Death
The Unavoidable Ending
ICU, the last line of defense for life.
If this position is lost, what awaits the patients is most likely the cold mortuary.
Here, tragic stories are performed every day. Outside the door, family members stand one batch after another, some staying late into the night, unwilling to leave. They sit in the corners, waiting for their loved ones inside, separated by the thick door.
The deceased from the neighboring bed has already been wrapped in white cloth and sent to the mortuary. The family members outside the door are crying so hard that they can hardly catch their breath.
The doctors around the bed disperse, and the nurses skillfully change the bed linen, preparing for the next patient.
The medical staff here do not have time to lament the death of a patient, to feel the grief of their parents and children, nor can they waste time on this.
What can be done at this moment is to devote themselves to the treatment of the next patient.
Lu Yinxi’s memory still lingers on the teaching rounds on the morning of the fifth day of the lunar month. At this moment, she heard a soft plea in her ear and quietly responded in her heart: “Okay, I will survive, I cannot die so inexplicably…”
She is willing to be a teaching patient, but she does not want to appear in their death case discussions.
At 6 PM, after getting off work, Jian Qing did not go to the ICU to accompany her right away. Instead, she went to the conference hall on the 7th floor of the administrative building to attend the hospital-level death case discussion.
Each department usually has its own time for death case discussions. The hospital-level death case discussion is a model brought back by a leader from a trip abroad to a foreign hospital, held only once a quarter. This is the third time.
The director of the medical department organizes the discussions, with each department taking turns to share. Sometimes experts from related specialties in other hospitals are also invited.
Examinations, diagnoses, medication, and resuscitation—every step is scrutinized for reasonableness. Clinical departments, medical technology, pharmacy, blood supply room… every department may be analyzed to see if they have fulfilled their responsibilities.
Patient death is a common occurrence for doctors, but it is not a glorious event. Standing here to accept discussion, even criticism, requires a certain amount of courage.
Speaking the truth here also requires a certain amount of courage.
In departmental death case discussions, it is easy for superiors to guide subordinates and point out where things were done poorly. However, hospital-level discussions are conducted with departments as units, and the major directors are all of the same rank.
When peers evaluate each other, they need to consider personal relationships carefully. Otherwise, if you embarrass a director in front of the entire hospital today, he may retaliate against you tomorrow.
Therefore, in these discussions, people tend to avoid heavy criticism, and the leader must repeatedly emphasize that it is a discussion and an improvement process, not criticism.
Sometimes the effect is not as good as internal departmental discussions, but the leadership has its own ideas, and the subordinates can only cooperate.
This time, it is the turn of the Cardiology Department to share cases.
A doctor from the Cardiology Department stood on the stage and opened the PowerPoint: “Good evening, leaders and colleagues. I am Ding Xiaomai from Cardiology Section One. Today, I am sharing a death case of a 20-year-old female who was admitted due to viral myocarditis (VMC). After treatment in the ICU, her condition once improved. She was transferred to the Cardiology Department on the 10th, and her condition was stable. On the 15th, during a follow-up examination, it was found that her heart failure had worsened and progressed to dilated cardiomyopathy (DCM) with low blood pressure. At 9:30 PM on the 15th, she suddenly suffered cardiac arrest…”
During the case sharing, the patient’s name was hidden, only showing the hospitalization number, 52104.
Jian Qing sat below the stage, unable to recall who that string of numbers represented, but upon seeing the medical history, physical examination, lab tests, admission diagnosis, and treatment course displayed on the PowerPoint, she guessed who the patient was—
He Bei, the patient who collapsed in the park that day and was jointly rescued by the emergency, critical care, and cardiology departments for nearly three hours.
Jian Qing had no time to lament the unpredictability of life and death, but furrowed her brows in thought.
The most dangerous moments were all rescued, so why did the condition suddenly progress to dilated cardiomyopathy (DCM) after stabilizing? And why did cardiac arrest occur, with resuscitation failing?
Nine o’clock in the evening.
Lu Yinxi lay on the ICU bed, opened her eyes, and her gaze was clear.
It was as if the heavy mountain pressing on her chest had been moved away, her breathing became smooth, and her muddled consciousness became clear.
Could this be the final radiance before death?
She turned her head to look at the data on her monitor.
All indicators were within normal range, and her vital signs were stable.
“Awake?”
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Someone walked to her bedside and asked her softly.
She moved her head and saw Jian Qing standing by the bed.
Jian Qing wore a mask, revealing only a pair of eyes, calmly looking at her: “Tomorrow, we can remove the tube.”
Lu Yinxi felt strength returning to her wrist, lifted it, and made a gesture as if holding a pen to write.
Jian Qing understood, raised the head of the bed, handed her a magnetic pen, and placed the magnetic board in front of her: “What do you want to say?”
Usually, Lu Yinxi would chatter non-stop, but now she couldn’t speak, so Jian Qing became the talkative one.
Lu Yinxi glanced at Jian Qing, then began writing and drawing on the magnetic board—
【Patient’s sutured wound: —IIIIIIII—
Instructor’s instruction to remove half: —I-I-I-I-I—
Student removed half: —IIIII —】
A classic medical joke, where a patient’s sutured wound was about to heal. The instructor directed the student to remove half of the stitches, the normal procedure being to remove every other stitch. However, the inexperienced student only removed the stitches on the right half.
She was telling a joke to make Jian Qing happy. She wanted to make her happy, not with this current serious and solemn look.
Jian Qing was expressionless.
Lu Yinxi frowned and glared at her.
“Not funny?”
Under the threat, Jian Qing pulled down her mask, hanging it on one ear, curved her mouth slightly, and showed Lu Yinxi a forced, brief smile, then put the mask back on.
Lu Yinxi did not tease her anymore, just looked at her.
Jian Qing also looked at Lu Yinxi. After a long time, there was a smile in her eyes, revealing a genuine smile.
The next day, Lu Yinxi removed the tube, covered with an oxygen mask, and after another day of observation, the doctor evaluated her vital signs as stable and transferred her out of the ICU, freeing up the bed, and into the respiratory department.
That day, Jian Qing was on a research shift, not staying in the laboratory, holding a laptop, and staying by Lu Yinxi’s bedside, compiling data.
In the general ward, she also wore a mask, but did not wear a white coat, wearing regular clothes.
Lu Yinxi stared at her, refusing to rest or sleep.
Wei Mingming, while running errands to deliver things, took the opportunity to visit Lu Yinxi, sitting at the head of Lu Yinxi’s bed, laughing and joking: “I am your lifesaver. When you get better, you have to dance for me.”
Lu Yinxi smiled and nodded in agreement.
Late at night, Jian Qing did not go back, planning to continue staying in the ward to watch over Lu Yinxi.
Lu Yinxi typed on her phone for her to see: 【You should go back and rest. The condition has stabilized, and with doctors and nurses around, I will be fine.】
Jian Qing glanced at it, looked away, ignored her, used the restroom in the respiratory department doctor’s duty room to wash up briefly, returned to the ward, and planned to sleep by the bedside.
Lu Yinxi poked the whirl on the top of Jian Qing’s head.
Jian Qing grabbed her hand, tucked it back under the quilt, looked up at her, and said nothing.
She had no choice but to type on her phone again: 【Why am I so seriously ill? Is it because my upper respiratory mucosal barrier function is too weak? Or is there something wrong with my immune system?】
Without underlying diseases, it takes a certain amount of time for a cold to develop into pneumonia. Even with pneumococcal infection, it usually takes 1-3 days after onset, without any medication or treatment, for it to possibly lead to severe pneumonia.
After being drenched in the rain and catching a cold, she got infected, feverish, and went into shock in just half a night. It was too rare. Was her immune system completely compromised, allowing bacteria to invade unchecked?
It was as if the Grim Reaper was pulling the progress bar of her life.
Jian Qing shook her head: “We’ve done many tests, and for now, we haven’t found any problems. It might be that your constitution is somewhat unique.”
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Just like how most people in this world need a certain amount of sleep, but some can manage to be energetic with just 2 or 3 hours of sleep.
“Wait for a while, continue with the examinations, and slowly find the cause. You should sleep first.”
Lu Yinxi: 【I can’t sleep. I’ve slept so long that I’m about to grow onto the bed.】
Jian Qing gently flicked Lu Yinxi’s forehead and said lightly, “That’s for loving to stay in bed.”
Lu Yinxi smiled, grabbed her hand, and held on.
Jian Qing let Lu Yinxi hold on, gazed into her clear eyes, and made a promise, “In the future, I won’t leave you alone.”
They say truth is stranger than fiction. Sometimes, her life, the things people around her experienced, were coincidental enough to resemble a novel.
She did not want to experience such coincidences again.
She wanted the person beside her to never leave her.
Lu Yinxi looked at Jian Qing, did not respond, just gave a faint smile.
A few days later, she gradually could speak and walk.
After walking a few laps in the ward area, Lu Yinxi could no longer bear the days of being confined to the ward. She told the head nurse and went downstairs for a walk.
The greenery design of First Affiliated Hospital of Jiangzhou was quite good. Although it was not as lush as the neighboring campus, there were still many flower beds, small pavilions, and long corridors for patients to walk, enjoy, and rest.
At noon, in the evening, and at night, people in the ward area like to come down for a walk and sit on the stone benches in the corridor to chat.
Lu Yinxi sat in the pavilion, observing the tree species. Jian Qing came over with lunch and asked in a calm voice, “Why did you come out without saying a word?”
“I told the nurse.” Lu Yinxi turned around, “Are we having noodles again for lunch today? When can I eat hairy crabs, fried shrimp, cumin lamb chops…”
Hearing her list a string of dishes, Jian Qing still remained expressionless and opened the lunch box, “First, eat this meal.”
Lu Yinxi muttered, “You are treating me like a child…”
Aren’t you pretending to be young?”
Lu Yinxi lightly snorted and lowered her head to obediently eat.
Next to the flowerbed, two chatting students were sitting: “Our group’s instructor hasn’t come to work for several days. I heard he took half a month off.”
“Teacher Chu Yan? Did something happen?”
“It seems like his fiancée passed away from illness. Hey, he originally said he was going to give us wedding candies.”
The intermittent chat drifted into Lu Yinxi’s ears. Lu Yinxi slowed down her chewing and swallowing, dazed for several seconds, then belatedly reacted and asked Jian Qing: “You said last time, Dr. Chu has a fiancée, when… when did he get a fiancée?”
Jian Qing’s face was calm: “After Miss He woke up, he proposed to her in the ICU rescue room, and Miss He agreed.”
They were originally long-acquainted neighbors. After enduring a thrilling rescue, almost experiencing life and death separation, they put aside their age concerns and decided to be together.
Lu Yinxi put down her chopsticks, trying hard to swallow the food in her mouth, but no matter what, she couldn’t swallow it. After gulping several mouthfuls of soup, she finally swallowed it down, and asked again: “He Bei, passed away from illness?”
Jian Qing coldly nodded.
She never had much affection for others. After seeing so many life-and-death separations in the oncology department, she couldn’t feel much emotion anymore. Even the slight regret she felt had long been diluted.
“When did it happen?”
“The fourth day of the Lunar New Year, the night you went into the ICU.”
The night of the death, it must have spread among the colleagues in the hospital. It’s just that during those few days, Jian Qing had almost all her attention focused on Lu Yinxi, and during her shift, her face didn’t look good, so no one dared to chat idly with her about those things.
Lu Yinxi found it hard to believe: “How could this be? She had clearly been transferred out of the ICU. The day before New Year’s Eve, I went to visit her, and her condition was still quite good.”
“On the second day of the Lunar New Year, she could get out of bed and walk, eat and drink, and seemed almost recovered. Her family asked the hospital for leave to take her home for a reunion meal. The hospital did not agree. On the third day of the Lunar New Year, they took advantage of the lawyer’s inattention and sneaked home. The hospital kept calling, and they only came back on the fourth day of the Lunar New Year. Upon return, examination revealed worsening heart failure. That night, she suddenly experienced cardiac arrest and could not be resuscitated.”
“Patients generally don’t like staying in the hospital for the New Year, finding it inauspicious. They would rather take the risk of sneaking home to celebrate the traditional festival with their family.”
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Lu Yinxi was momentarily speechless.
Jian Qing continued to explain softly, “The trigger for the death might have been that day they went home on the third day of the Lunar New Year. She didn’t bring her medication and suddenly stopped taking Betaloc, leading to myocardial infarction.”
He Bei had been prescribed Betaloc due to tachycardia. Betaloc, which has the function of slowing the heart rate and dilating blood vessels, is a type of beta-blocker. This type of medication should not be stopped abruptly but should be tapered off gradually. Otherwise, it can cause a rebound effect, worsening the original symptoms, inducing angina, or even causing myocardial infarction.
Lu Yinxi suddenly lost her appetite and couldn’t eat anything.
She coughed a few times, stood up, turned her back to Jian Qing, and looked at the green tree outside the pavilion.
This tree seemed to be quite old, with twisted and intertwined roots, crisscrossing each other.
She looked at the green tree, her mind in a turmoil.
After all the twists and turns, why couldn’t she escape the conclusion of death?
The author has something to say:
A promise from a sickly sweet lover—
On the surface: I will not leave you alone
Subtext: You are not allowed to leave, even if you die, you must die in front of me
I worked overtime, came back late, sorry, mwah mwah to everyone~~~