Volume 1: Rise
Stars
The meaning of death and life
When she woke up again, it was early morning, and the hospital room was empty. Gu Yanzhi laboriously opened her eyes and stared at the snow-white ceiling in a daze for a while. Her gaze fell on the liquid bag to the side, which had already finished infusing. She raised her hand to press the bell, waiting for the nurse to come and change the medicine.
She fell into a drowsy sleep again for a while, her throat burning intensely. She reached out muddleheadedly for the kettle of boiling water on the bedside cabinet. Because of the distance, she had to stretch her arm long, and the infusion stand connected to her other hand was swaying precariously.
Lu Qingshi, after verifying her fingerprint, came in just in time to see this scene. Instantly, she rushed over in one swift step to steady the infusion stand, simultaneously taking the scalding kettle from her hand.
Gu Yanzhi breathed a sigh of relief, a smile appearing on her face as if she hadn’t noticed the danger: “You’ve come.”
When she saw that the blood in the soft tube connected to the indwelling needle on the back of Gu Yanzhi’s hand had already returned halfway, the usually calm person gently pressed her lips together tightly.
A sign of getting angry.
Lu Qingshi took a clean disposable paper cup from the bedside cabinet and poured her a cup of water, then slightly raised the bed a bit so she could sit up to drink.
The nurse who rushed in afterward was still explaining: “Sorry, Director Lu, sorry, Captain Gu, today Director Xu required everyone in the department to be present for the big ward round…”
“No problem…” Gu Yanzhi still wanted to say something, but Lu Qingshi gave her a cold glance.
She obediently closed her mouth.
“Are you the nurse responsible for this bed? If the patient presses the bell and you can’t hear it, that’s one thing, but not being able to adhere to the ten-minute ward round system written in the work details is another. You might as well pack up and go home. Call your head nurse over; I want to change the responsible nurse.”
The responsibility nurse follows the patient from the moment they enter the hospital until they leave. It is a core task in daily nursing that doesn’t require night shifts, and there is significant room for future promotion. The young nurse was so anxious she almost cried, continuously bowing and apologizing.
Lu Qingshi took out her mobile phone from her pocket, preparing to call the nurse station, but was stopped by someone. An excessively pale finger rested on her wrist.
Gu Yanzhi smiled, with an abnormal flush on her face: “Let it go, Doctor Lu, I’m fine…”
Lu Qingshi placed her hand on Gu Yanzhi’s forehead, and extended her other hand to the nurse: “Let me see the medical record.”
The nurse hurriedly handed it over.
“How did she suddenly come down with a fever?” she frowned while flipping through the records, her other hand sliding down from Gu Yanzhi’s forehead. Gu Yanzhi watched that slender, fair hand leave her, feeling a small sense of disappointment in her heart.
“Who issued this medical order?”
“It was… Director Xu… who said this new drug is very good for anti-infection, and many patients are using it…”
Lu Qingshi slapped the medical record face down on the desk: “Stop it for me. The medication method should still follow my previous dosage. After completing one course, we’ll check and then reconsider the medication plan.”
The young nurse lowered her head, not daring to answer.
Lu Qingshi walked up to her, poking the treatment record against her: “What, even though I’m suspended, my title is still there, and our medical team is still in need of a nurse.”
The young nurse quickly received it with both hands, complaining internally, caught in the difficult position between two major department directors.
“Yes, but on Director Xu’s side…”
“Proceed confidently, if there’s a problem, let him come to find me.”
Gu Yanzhi finished one cup of water, and when she was halfway through the second, Lu Qingshi took it away.
“Don’t drink too much in a short time, wait half an hour and then drink again.”
Gu Yanzhi, feeling helpless, had to obediently follow the doctor’s advice: “Why did you come today?”
“I came for a re-examination.”
She looked around the empty hospital room. Gu Yanzhi had been living here alone for more than half a month. Except for the occasional visit from the fire brigade, it was all cold and quiet.
She hesitated for a moment but still asked her question: “What about your family?”
“I am an orphan,” the other person answered quickly, as if not bothered by this somewhat sensitive question.
Lu Qingshi had seen too many people who, because of their tragic backgrounds, wallowed in self-pity, their faces all showing a surprisingly consistent cynicism.
Gu Yanzhi was an exception, appearing extremely calm: “I grew up in the orphanage until I was five years old, when my adoptive father took me home.”
“And where is he now?”
“He died in a big fire three years ago.”
Lu Qingshi was silent: “I’m sorry…”
Having lost her only relative in the world, Gu Yanzhi was indeed sad for a long time before she came out of the shadows. However, being naturally optimistic, when she talks about these things now, her eyes only show remembrance.
“To die on his own post, for a firefighter, is considered to die with honor.”
(If you're not reading on littlepandatranslations.com, it means this has been stolen)
Lu Qingshi chuckled softly: “You truly have an open mind.”
“Then what else? Life must go on. Some people say that after people pass away, they become stars in the sky. If you think of it this way, on clear nights, my dad will always be with me.”
“What about nights without stars?”
“Then he is the star in my heart.”
“Mama, will I die?” The chemotherapy had made the child’s once black and shiny hair fall out completely. Lu Qingshi squatted down, cupping his pale, young face, and kissed his forehead.
“You won’t. With Mama here, I won’t let anything happen to you, Lele.”
A small child sat in a wheelchair, like a little adult, reaching out to hug her neck: “Mama, don’t be sad. Papa said Lele is a little man, must be strong, must protect Mama. When you want to cry, just look up at the stars, and the tears won’t fall.”
That was her last conversation with Lele. So many years have passed, yet she still remembers it was a star-filled night, with Lele sitting in the wheelchair as she pushed him by the window to watch the shooting stars.
Regarding Lele, she never forgets but also never mentions him, trying to avoid any topics related to death and life. After being expelled from Xiehe Hospital (aka Peking Union Medical College Hospital), she went far overseas and, upon returning to the country, chose to work at Renji Medical University, thousands of miles away from home, for one reason: to avoid a place of sadness.
Her home has no children’s items, not even a photo of her son, overly clean to the point that even Qin Xuan complained it’s not a place for people to live.
When she left Xiehe, she took nothing with her, and now she is still alone. She deliberately avoids, which to some extent has already caused physiological forgetting. If not for Gu Yanzhi’s serious injury and near-death state, this would still be the deepest dust pressed in her heart, and one touch would bring the dust along with overwhelming pain.
She frowned, suddenly feeling unable to breathe.
Gu Yanzhi noticed her expression was off and reached out to grab her wrist: “Doctor Lu, Doctor Lu?”
Lu Qingshi came back to her senses, her clothes soaked with sweat, and her face looking very pale: “What happened?”
“I… I want to go to the bathroom…”
After she woke up, she insisted on not using a catheter. Even though she was seriously ill, she wanted to maintain the last shred of dignity as a human being.
Lu Qingshi understood and respected her decision, so she reached out to help her up: “Come, I’ll support you.”
“No, no, no, just call a nurse…” Gu Yanzhi declined, but she had already placed her hand on her shoulder, with the other arm around her waist.
Gu Yanzhi had no choice but to follow her lead to stand up: “Thank you, Doctor Lu.”
Unlike Lu Qingshi, who conducted her rounds simply and efficiently, Xu Qiankun wished he could call the entire department and announce with a loudspeaker to the whole hospital: Director Xu of the Emergency Department is starting his rounds.
The scene common in medical dramas, where a group of lower-level medical staff in white coats follows the leader down the corridor, finally reappeared. They spent the whole morning walking, with Xu Qiankun shaking hands with every patient. Yu Gui rolled her eyes, feeling that Xu had more talent for being a national leader than a doctor. She couldn’t help but reminisce about when Lu Qingshi managed the ward, conducting each round swiftly and decisively. Sometimes she even found the interns’ many questions troublesome and would bring a few attending physicians to quickly familiarize themselves during rounds.
Unlike now, just as they left the ward: “Oh, bed eleven there, what did they say?”
The attending physician following immediately replied: “The patient’s main complaint is chest pain.”
“Contact the radiology department for an X-ray.”
After Xu Qiankun finished speaking, he glanced at his wristwatch: “Alright, that’s it for today. I have surgery this afternoon, so Doctor Hu will lead the remaining rounds.”
The clock on the wall had just passed eleven, and everyone had to bow and say goodbye to him: “Director Xu, thank you for your hard work.”
He took two steps, then suddenly turned his head to look at everyone, frowning as if searching for someone.
Yu Gui, holding a medical record folder, shrank back in the crowd, unexpectedly getting called by name.
“Yu Gui”
Everyone’s gaze instantly turned toward her, and she had to brace herself and step forward: “Director Xu, do you have any instructions?”
“I heard from Director Lu that you’ve been doing well recently. You’ll be the third assistant in the afternoon surgery.”
Although she was only the third assistant, it was enough to draw envious, jealous, and dissatisfied looks from her peers. Becoming the apprentice of a department director as soon as she arrived and being personally chosen by another director to assist—what kind of dumb luck was this?
Yu Gui secretly complained to herself: “Yes, thank you, Director, for your guidance.”
Being the third assistant only meant helping with suction and such things; she likely wouldn’t be asked to suture. With her suturing skills, as Lu Qingshi put it: even a dog would dislike them.
She knew her own limitations clearly and didn’t want to embarrass herself in front of Xu Qiankun.
The afternoon arrived quickly. Yu Gui and several other assistants arrived early in the operating room for pre-surgery preparations. The anesthetist was also quickly in place. After the general anesthesia and intubation were completed, the patient was pushed into the operating room. The instrument nurse brought the instruments over. Unfortunately, Hao Renjie was supervising today. The two comrades-in-arms exchanged a glance and silently went about their work.
Yu Gui’s senior colleagues started disinfecting the patient, eager to begin, and Yu Gui leaned over: “Aren’t we waiting for Director Xu?”
Her senior colleague glanced at her: “Director Xu only handles the critical parts; we complete the other work.”
In the operating room’s hierarchy system, although Lu Qingshi occasionally allowed junior doctors to operate, in most situations, she would be present to oversee.
Yu Gui nodded, indicating her understanding.
(If you're not reading on littlepandatranslations.com, it means this has been stolen)
This was a simple laparoscopic cholecystectomy1. Her senior colleagues moved quickly, efficiently making three incisions at the patient’s navel, beneath the xiphoid process2, and in the right upper abdomen. Yu Gui assisted by holding the scope and doing some suction work.
The main surgeon was Xu Qiankun’s apprentice, an attending physician in his early thirties. Although young, he was still considered experienced at Renji Medical University, a top-tier hospital with a high patient volume. Moreover, since the patient had no other complications, the surgery proceeded smoothly.
After cutting the serosa3, the gallbladder triangle area4 was exposed. The electric hook was switched to blend mode, and the main surgeon carefully dissected to avoid accidentally injuring the nearby liver tissue.
“Senior brother, why not use electrocautery5? Doesn’t it help reduce bleeding?”
The second assistant beside her gave her a look: “Just watch, this is Director Xu’s unique skill. Using blend mode is less likely to burn liver tissue.”
“Oh,” Yu Gui responded, drawing out the sound.
“Move the observation scope a bit higher.”
“Okay.”
The main surgeon was carefully operating while observing the large screen. The electric hook gently maneuvered the gallbladder but suddenly stopped, as cold sweat immediately dripped down his forehead.
“Not good, the bile duct is exposed on the liver surface, and we can’t cut it, as it will cause massive bleeding. Quickly, go call Director Xu!”
Xu Qiankun arrived quickly upon hearing the news, observed for a moment, and indeed, the director still had some skill: “Remove the laparoscope6 and bring over the instruments needed for open-chest surgery.”
Hao Renjie and the instrument nurse pushed over the necessary items together, while also preparing the drainage tubes.
“Surgical knife.”
“Chest retractor.”
“Monopolar electrosurgical knife.”
The smell of burnt meat spread out, and Yu Gui began to feel nauseous.
One major advantage of open-chest surgery is that bleeding can be promptly detected and quickly stopped. However, the situation everyone dreaded most happened when they were dissecting to the bile duct.
The blood recovery tank instantly filled with a large amount of blood, and Yu Gui’s hand holding the suction device began to tremble. She slightly turned her head.
Xu Qiankun remained calm and pressed gauze onto the site: “Give me the absorbable clip.”
As he worked, he explained: “In the event of massive bleeding, do not panic. First, press with gauze, then clip. Be careful not to ligate the right hepatic artery7 while clipping. There, that’s fine.”
He used tissue scissors to cut off the gallbladder and placed it into the kidney dish: “Send for pathology.”
Hao Renjie quickly took it and ran out of the operating room.
Xu Qiankun released the clip holding the ascending blood vessel with the hemostatic clamp, and no more blood flowed into the recovery tank. He also breathed a sigh of relief: “Alright, you young people can handle the rest. Remember, when suturing, keep it loose inside and tight outside, or it might split.”
The senior brother who had just been the main surgeon was almost moved to tears, looking at him as if he were a god: “Thank you, Director Xu, for your guidance.”
The second assistant beside her nudged her arm after Xu Qiankun stepped down: “See, Director Xu is both skilled in medicine and a good person, so much better than Lu Qingshi.”
Yu Gui couldn’t understand; it was just an ordinary cholecystectomy. Isn’t this the level a department director at a top-tier hospital should achieve?
As for his character… she really couldn’t say.
Over there, the anesthetist was urging them: “Move faster, this patient’s cardiopulmonary function8 isn’t good, and the anesthesia time is about to end.”
Yu Gui glanced at the wall clock; four hours had passed.
“Instrument nurse, count the gauze, and prepare to close the abdomen.”
“Okay,” the instrument nurse counted once: “Everything’s accounted for, we can close the abdomen.”
“Wait a moment,” Yu Gui glanced at the closed operating room door: “The circulating nurse hasn’t returned yet. Don’t we need to confirm again?”
“There’s no time. If we delay further, the patient might die on the operating table due to cardiopulmonary failure.”
That was the last thing the anesthetist wanted to see: “Exactly, exactly, hurry up.”
Yu Gui always felt something wasn’t right, feeling absent-minded. Finally, Hao Renjie returned from sending the pathology report, and Yu Gui nudged him: “Count the gauze again.”
Hao Renjie rolled his eyes: “You’ve watched too many medical dramas. Forgetting gauze in a patient’s belly is impossible in our hospital.”
Everyone let out a burst of laughter, and Yu Gui’s face turned slightly red, but she still insisted: “Count, count again!”
The main surgeon was not having it: “Hey, newcomer, what do you mean by this? Are you questioning Director Xu’s ability or my operating method?”
“I…” Yu Gui said stubbornly: “I… just want to confirm.”
“Confirm what?! If you think you can, then you do it. Come on, let us see and experience Director Lu’s prized disciple’s suturing technique.”
Before the main surgeon could speak, the second assistant pulled her to his position and placed the surgical knife in her hand.
(If you're not reading on littlepandatranslations.com, it means this has been stolen)
“I…” Yu Gui hesitated, looking at the surgical knife covered in blood in her palm: “still… you better do it.”
When Lu Qingshi lay down to prepare for a CT scan, her phone rang. She turned over and got up, making an apologetic gesture to those outside: “What’s the matter? Speak quickly.”
“Teacher Lu, there was a laparoscopic cholecystectomy, but because the bile duct adhered to the liver surface, it was temporarily changed to open-chest surgery. Now they’re preparing to close the abdomen, but I feel…”
She hesitated for a moment: “Just now, when Director Xu was stopping the bleeding, I saw him stuff a piece of gauze inside, but he didn’t take it out.”
She covered the receiver and spoke very cautiously.
Lu Qingshi listened and remained calm: “I have already been suspended; it has nothing to do with me.”
“Director Lu, the phone needs to be put away,” the nurse came in to collect the phone. She handed the phone to the nurse and lay on the CT bed, which slowly moved into the scanning machine.
“There is no major problem, just a slight bone fracture caused by the prolonged delay. Avoid intense exercise recently, take your medication on time, and come back for a follow-up.”
The orthopedic director handed the film to her, and Lu Qingshi bent down to bow in thanks.
As she walked down the hospital corridor, she saw Xu Qiankun from a distance, walking with several people in suits, both men and women.
“Sorry, sorry, a surgery delayed me, let’s go.”
“Not at all, Director Xu handles myriad affairs daily; having the honor of dining with Director Xu is our privilege.”
The female secretary opened the car door for them, and Xu Qiankun got in as the Mercedes-Benz sped away.
Lu Qingshi clenched the image bag in her hand. According to regulations, she could no longer enter the operating room, but…
She turned and handed the image bag and medicine bottle to a passing nurse: “Emergency, Lu Qingshi, please help me put these at the triage desk, thank you.”
Footnotes
- Laparoscopic cholecystectomy: A minimally invasive surgical procedure to remove the gallbladder, typically performed using small incisions, a camera, and specialized instruments.
- Xiphoid process: The small, cartilaginous lower part of the sternum (breastbone) that gradually ossifies into bone in adulthood.
- Serosa: The outermost layer of certain organs, consisting of a thin layer of connective tissue covered by a simple squamous epithelium, which helps reduce friction between moving structures.
- Gallbladder triangle area (also called the Calot’s triangle): An anatomical region formed by the cystic duct, common hepatic duct, and the inferior edge of the liver, crucial in identifying structures during gallbladder surgery.
- Electrocautery: A surgical technique that uses electric current to heat a metal wire or probe to cut tissue or stop bleeding by coagulation.
- Laparoscope: A thin, flexible tube with a camera and light at the tip, used in minimally invasive surgeries to visualize internal organs and guide surgical instruments through small incisions.
- Right hepatic artery: A branch of the common hepatic artery that supplies oxygenated blood to the right lobe of the liver. It often runs through or near the gallbladder triangle, making it important to identify during liver or gallbladder surgery.
- Cardiopulmonary function: Refers to the combined performance of the heart and lungs in delivering oxygen to the body and removing carbon dioxide, essential for maintaining cellular function and overall health. It involves the heart pumping blood and the lungs facilitating gas exchange during respiration.