Although Jiang Xu had already decided to administer the antidote before the blood test results came out, he feared it might still have been too late.
Two minutes later, the patient’s blood oxygen saturation suddenly began to plummet. The ER nurse looked at Jiang Xu anxiously, but before he could react, Chen Qi’s voice rang out sharply, “Dr. Jiang, the fetal heart rate baseline is elevated with reduced variability!”
—The fetus was very likely already showing signs of distress in the womb.
Liu Ran’s face was full of shock. “How could that be?”
Jiang Xu glanced at him. “Midazolam for sedation, plus vecuronium bromide for muscle relaxation.”
Shen Fangyu picked up immediately, “Prepare for endotracheal intubation.”
The door suddenly burst open. A nurse came in holding the lab report, handed it to Liu Ran—who was the closest—and reported to Jiang Xu at the same time: “Cholinesterase activity has dropped below normal; organophosphate pesticide concentration is 135 ng/ml.”
It really was organophosphate poisoning!
Having just finished the gastric lavage, Liu Ran stared at the blood test sheet in disbelief, flipping it over several times. “How could this be?” He handed the report to Jiang Xu, his expression a mix of incredulity and a subtle trace of admiration. “How did you know?”
“There’s no time for a lecture now,” Jiang Xu said. “The patient’s symptoms were not obvious; the dose was likely small.” He took the second test sheet the nurse brought in, his gaze gradually darkening.
Even after gastric lavage and administering the antidote, Zhang Yun’s vital signs were still far from ideal.
“We’re behind in the rescue.”
Although the pesticide dose was small, it had already entered the bloodstream. Because of the earlier delay, both the lavage and the IV atropine had come too late.
“What does the family say?” Jiang Xu asked the nurse.
“They still insist the patient never ingested pesticide.”
“Understood,” Jiang Xu replied coolly, showing no expression.
His eyes stayed fixed on Zhang Yun’s blood oxygen reading on the monitor—but inevitably, the exact outcome he least wanted to see still appeared.
Intubation failed to restore the dangerously low oxygen level. Shen Fangyu let out a sigh. “Contact the ICU and prepare for hemoperfusion. We can only pray the fetal heart rate recovers.”
Since the pregnancy was already full-term, no one wanted this child to be born prematurely now. If the fetal heart rate remained stable, the baby could have stayed safely in the womb for another two months.
But whether it was fate or simply bad timing, almost the instant Dr. Shen finished speaking, Xiao Chen cried out, “Fetal heart rate baseline at 150 bpm, variability extremely poor!”
Jiang Xu cast Shen Fangyu a helpless look. Shen, looking utterly dejected, defended himself, “I swear I’m not jinxing it.”
But as soon as he spoke, he suddenly remembered that just tonight, while eating skewers, he’d joked about whether Jiang Xu disliked him because he’d gotten him pregnant…
“After this surgery, I’m taking a vow of silence,” Dr. Shen promised first.
With the fetal monitoring showing this situation, Jiang Xu knew there was no other choice.
To save the mother, hemoperfusion was the last hope.
If they delivered the baby first, it would delay the start of hemoperfusion—and with Zhang Yun’s current condition, every lost second could be fatal. But if they didn’t deliver, this eight-month-old fetus would quickly become stillborn, delivering a second blow to the already fragile mother, affecting the hemoperfusion process.
Moreover, hemoperfusion would alter the mother’s hemodynamics, likely triggering contractions or membrane rupture prematurely. If that happened, hemoperfusion would have to be stopped, and the risk of fetal asphyxia would also rise.
In reality, there are none of those melodramatic “save the mother or the baby” ultimatums seen in TV dramas. In most life-and-death situations, mother and child share one fate, thriving together or perishing together, tightly bound by a single umbilical cord, their lives tied as one.
And doctors never truly set such choices, nor ask families or patients to make them.
Every doctor will do everything possible to save both mother and child.
For Jiang Xu and Shen Fangyu, there was only one path forward.
Race against time to deliver the baby as quickly as possible, then immediately send the mother for hemoperfusion.
And this choice, without a doubt, was an enormous challenge to the surgeon’s mindset and skill—so demanding it was terrifying.
“Transfer to the operating room.”
“Move fast!”
With the two doctors giving the final word, all the medical staff involved in the rescue instantly began pushing equipment and the delivery bed toward the OR. As they rushed down the corridor, Jiang Xu spoke at a rapid-fire pace without a single pause: “Keep monitoring the fetal condition, prepare for a C-section to terminate the pregnancy, monitor the oxygen saturation in real time—”
The pace was so fast he couldn’t help but take a breath, and Shen Fangyu immediately picked up, “Request a neonatology consult, inform the ICU to prepare for hemoperfusion, tell them we’ll be done here very soon!”
In critical care emergencies, every second is a race against death. But in obstetrics, death is far too greedy, wanting to take two lives at once.
Just as the team reached the doors of the operating room, a burly man suddenly stepped in front of Jiang Xu, grabbing him by the arm. Jiang Xu looked down at him, baffled, and the man quickly said, “Doctor, that’s my wife you’re pushing, remember, if anything happens, you must save the baby, save the baby!”
Without a word, Jiang Xu shook off his arm.
“Save your damn uncle!” Shen Fangyu, following right behind, was already in a foul mood. Hearing that, he shot the man a cold glare. “Next time you come to a hospital, remember to bring your face with you. If you don’t have one, turn left to the eighth floor, plastic surgery department.”
Usually smiling, Shen’s sudden cold expression was surprisingly intimidating. The man flinched and avoided his gaze.
A hospital is the place that sees human nature most clearly. In obstetrics, there is love that makes every doctor and nurse envious—and scum that make you curse even after the words run out.
The stubbled man watched the OR doors close in front of him, then spat viciously and muttered, “What kind of doctors are you? No medical ethics at all! I’m gonna damn well file a complaint!” Then he grabbed a passing nurse and barked, “What are the names of those two pretty boys who just went in?”
The nurse gave him a withering look and called out in disgust, “Security—”
Meanwhile, Jiang Xu and Shen Fangyu quickly scrubbed in. Sterile water splashed down in a rush as the two stood side by side.
“I’ll take lead,” Jiang Xu said directly. He tilted his head toward Shen Fangyu. “You’ll assist me.”
“You’re asking an associate chief physician to be your first assistant?”
“Didn’t you just say in the office that you’d follow my lead?” Jiang Xu countered flatly, his hands never pausing.
That office conversation had been an argument about the child. Shen Fangyu stared in disbelief. “Your mood shift is way too fast.”
Jiang Xu ignored him completely and instead turned to a young doctor beside them. “What’s your surname?”
Chen Qi was relatively junior, from another hospital for standardized training, and not part of Jiang Xu’s team, so they didn’t know each other.
“Dr. Jiang, my surname is Chen.”
Jiang Xu nodded. “You’re in too.”
Inside the OR, the anesthesiologists had already set up the equipment and ECG monitor. Two shadowless surgical lamps flicked on at once, flooding the patient on the table with bright light.
When Jiang Xu, now in sterile gown and gloves, stepped up to the table, Shen Fangyu had naturally taken the first assistant’s position.
Jiang Xu glanced at him. Shen looked up at the ceiling and said, “Saving lives comes first. I’ll let you win this time.”
He lowered his eyes, glasses hiding the slight flicker in them.
Author’s Note:
A huge thank you to reader “ccaa” for tossing a landmine ×1—thank you for your support, sending love and bows~
References for this chapter and the following ones about this case:
[1] Zhu Wenting. Nursing Care of a Case of Organophosphate Poisoning in an Over 8-Month Pregnancy [J]. Everybody’s Health (Academic Edition), 2015, 9(24): 266.
[2] Wang Chunfang, Yin Sufang, Pan Yannian. Nursing of 19 Cases of Organophosphate Pesticide Poisoning During Pregnancy Treated with Hemoperfusion [J]. China Health Standard Management, 2013, 4(21): 40-41.
[3] Zhang Juan. A Clinical Nursing Case of Organophosphate Pesticide Poisoning at 8 Months’ Pregnancy Leading to Preterm Birth [J]. Qilu Journal of Nursing, 2013, 19(02): 99-100.
This case was adapted from my teacher’s personal experience.
Whenever I’m unsure, I look up textbooks and literature, trying my best to avoid major errors. But I make no professional guarantee on any medical knowledge here, at heart, this is a romance novel with a medical backdrop. The details serve the plot, so just enjoy the story. Thank you for understanding, bows!