Lu Junran turned and walked back into the hospital inpatient building, ready to face his 24 hours on duty.
Contrary to what Ye Wushu had imagined, Lu Junran wasn't flustered at all—he handled everything with remarkable composure.
Having the nurse renew medications was the simplest task; he'd studied for a week, and he wasn't stupid—he'd already learned that.
As for the other procedures? Lumbar punctures? Dressing changes? Drain tube replacements?
Lu Junran simply @-mentioned his home department in the group chat, saying it was neither his duty nor something he knew how to do.
If it was truly a patient under his own care, then he'd call in reinforcements.
When the nurse reported that Bed 5's oxygen saturation was poor and the attending physician ordered intubation, Lu Junran called the anesthesiology department.
The newly appointed female chief anesthesiologist came grumbling to perform the intubation, then made them sign the consent form: "Can't your ICU intubate patients yourselves?"
Lu Junran smiled politely: "I'm just a student—my attending told me to make the call."
And with that, she had nothing more to say.
Family members causing trouble?
Lu Junran simply retreated to a safe distance and called security—his philosophy being that work is work, but personal safety comes first.
As for writing medical histories, he'd just copy and paste the progress notes his junior colleague had written the day before. If it was a new patient, ICU admissions usually came with a discharge summary from the referring hospital. If they'd been treated at this hospital all along, it was even simpler—no typing needed, just one-click import.
Lu Junran had nothing left to do by 5 PM. He opened WeChat and checked repeatedly—his junior colleague hadn't sent him any messages. He tapped on her profile picture and saw she'd posted a status update:
[First week on the job, and I've already got gastroenteritis. Ugh, ugh, ugh.]
He wasn't the first to see the post, because Zhao Hongxi had already commented below: [What happened? Did you eat something from the cafeteria?]
The cafeteria's reputation took another daily hit.
Lu Junran hesitated no longer and opened the chat with his junior colleague: [Are you feeling any better?]
[Not really.] Ye Wushu attached a crying emoji. She'd just requested leave from the teaching secretary, who told her to coordinate with Lu Junran and submit the leave request through the OA system.
[I need to take a day off tomorrow. Sorry for the trouble, Senior.]
[No problem.]
Lu Junran racked his brain but couldn't think of anything else to say, so he ended the conversation there.
As it turned out, the ICU was never calm for long. Lu Junran had a peaceful day, but the night shift brought him trouble.
An elderly postoperative patient from thoracic surgery said she couldn't sleep, but when they prescribed her sleep medication, she refused to take it. Since she didn't have an oral endotracheal tube, they didn't dare give her sedatives for fear of respiratory depression.
The old lady kept pressing her call bell, summoning the nurse, who in turn summoned Lu Junran. After several rounds of this, the nurse figured it out—the old lady needed emotional comfort.
After the third time, the nurse whispered to Lu Junran: "She's treating you like her own son."
Lu Junran: "…"
Lu Junran said to the old lady: "Since you can't sleep, how about I call your son to come chat with you?"
The moment she heard he'd call her son, she immediately objected. "He has to work tomorrow, and he lives far away. Just give me a sleeping pill—the cylindrical kind I usually take."
So Lu Junran looked at the photo on the old lady's phone and prescribed her half a tablet of Stilnox, stat.
He had a biological father, mediocre as he was, but he wasn't about to become someone else's son.
There was also a post-craniotomy patient whose tube had been removed. At 1 a.m., he suddenly became unresponsive with unequal pupils. Lu Junran called for today's senior on duty while simultaneously phoning the neurosurgery resident on call: "Senior, we've got a case. ICU bed 23 on the 6th floor, possible postoperative cerebral hemorrhage, GCS score of 3."
The senior arrived within three minutes and wanted to bring his junior along to assist in the OR, but the junior politely declined.
Lu Junran said, "I'm on ICU duty today."
The senior could only leave with regret.
Just then, bed 24 beside them suddenly began gasping for air. Today's senior on duty, Ni Li, and Lu Junran hadn't even left the ward before rushing to the bedside.
Ni Li pulled a stethoscope from his pocket, and the nurse beside him reported: "This patient has a history of diabetes, but we checked his blood glucose tonight and it was all normal." Diabetic ketoacidosis was ruled out.
Ni Li said, "Check it again."
After a moment, Ni Li looked up with a grave expression: "Heart failure. Push a dose of Lasix—10mg furosemide—and stop the fluids for now."
Watching the oxygen saturation continue to drop, Ni Li made a decisive call: "Bring the ventilator over, open the crash cart, and prepare for intubation."
In a critical situation, they couldn't wait for anesthesia to arrive, but Ni Li still had Lu Junran make the call: "If we can't get the tube in, anesthesia is our backup."
The nurse prepared the suction device nearby. As soon as the video laryngoscope blade went in, a flood of pink frothy fluid surged from the oral cavity.
The machine blared its alarm, and oxygen saturation plummeted rapidly.
Ni Li had no choice but to bag-mask ventilate while waiting for the anesthesiologist to arrive.
Under these circumstances, he didn't dare try again. He was originally a general surgeon before joining the ICU—when it came to intubation technique, he was still no match for physicians trained in anesthesia.
Most importantly, after years of practice, he knew well not to overreach. Ask for help when help was needed. Intubation only gets harder with each attempt, and it could trigger airway spasms—better to wait for backup.
Fortunately, anesthesia was highly proficient at emergency intubations. Less than two minutes after Lu Junran's call, the anesthesiologist appeared in the ICU.
Zong Xiahuai sprinted in carrying her emergency intubation kit, because the phone call had told her the oxygen saturation was unreadable.
When she arrived and saw the saturation was still at 90, she breathed a sigh of relief—there was still room to work.
"Make way, everyone." Zong Xiahuai pulled out her intubation equipment. "Push another 3ml of propofol."
As a seasoned intubation veteran, Zong Xiahuai secured the airway in 30 seconds and once again expressed her disdain for ICU intubation skills: "Why don't you guys rotate through our department for two months and get some training?"
Ni Li chuckled and said, "I'll suggest that to our director next time."
"What's the story with this patient?"
"GI surgery patient, partial hepatectomy. Had massive intraoperative bleeding, then post-op liver failure, so he's been here since. The family's resuscitation wishes are very proactive—they've already signed all the consent forms."
Zong Xiahuai gave an "OK" sign and had Ni Li sign her anesthesia department paperwork.
After the anesthesia team left, Ni Li gave Lu Junran a teaching moment: "This patient was fine during the day, then suddenly went into heart failure at night. This kind of situation is very dangerous—you need to stay alert."
Ni Li then asked, "I heard you're a surgery trainee—which department are you in?"
Lu Junran said, "Neurosurgery."
Ni Li turned to look at him. "Which attending's group?"
Lu Junran: "Professor Shao Hua's."
Ni Li paused for three seconds. "Oh, then just pretend you didn't hear what I said earlier. Anyway, your department's patients go straight to the ICU after surgery—someone's there to keep an eye on them, so you don't have to worry."
Everyone knew that in this hospital, no matter how big or important anything else was, neurosurgery reigned supreme.
Ni Li's tone suggested he harbored some resentment toward neurosurgery, but Lu Junran didn't pick up on it. He simply said, "Okay."
4:30 AM.
The patient who had been wheeled out for a "second trip" to the OR at 1 AM was back. The anesthesiologist arrived with the patient first, and the neurosurgeon followed right behind.
"Don't extubate this patient. Put him on sedation. The post-op CT still shows some hematoma—about 5 to 6 ml. Repeat the CT in the morning. If there's no change, we'll leave it as is. If it's enlarged, he might need a third trip."
"Will you be off your shift by then?" the senior resident said. "Come scrub in with us."
As everyone knew, surgeons never got post-call days off. It was perfectly normal to go straight into the OR with your team the day after being on call.
Lu Junran: "I still have to work tomorrow."
The senior said, "What's so important about an ICU shift? Come on! Come operate with me! Doesn't the ICU have any other doctors?"
The senior turned to Ni Li beside him. "We're borrowing him for a bit."
Ni Li was furious but didn't dare say anything. He said to Lu Junran, "Then go ahead and handle that first. Isn't Little Ye covering tomorrow anyway?"
If Lu Junran went to the OR, Ye Wushu would have to come in to work. Lu Junran found an excuse to decline: "Forget it. The education department is cracking down hard these days. I shouldn't skip shifts casually. Next time—I'll definitely come next time."
The senior didn't push it.
It was already 5 AM, and through the ICU windows, the sky was beginning to show signs of dawn.
Lu Junran sat in the work area for a while, looked at his phone, and tapped into his junior's Moments. She had replied to Zhao Hongxi's comment:
[No, it's takeout.]
Lu Junran read it over and over, wishing he could crawl into Ye Wushu's phone and comb through every trace of their conversation.
He also saw the post from when she'd gone out to eat. In the last photo, she was smiling brilliantly, as if looking through the camera lens at him on the other side of the screen.
Lu Junran's heart was racing.
After careful consideration, he decided it was because staying up all night had worn him through.
Lu Junran lay in the on-call room until past 7, then got up for handover, did rounds, and started processing the medication orders the nurses had posted in the group chat. He waited until 9 AM, when his junior sent a message: [Senior, how was your shift last night? I feel much better after sleeping today. How about I come relieve you, and you go home and rest a bit?]
Lu Junran had been on call the previous night. Per ICU policy, he was entitled to half a day off—but since Ye Wushu wasn't working today, he couldn't take it.
Without hesitation, he typed out [It was fine, not too busy. No need.]
He typed and deleted on his phone, mulling it over for a full ten minutes, until he finally asked: [I saw Zhao Hongxi commented on your Moments. Have you two been chatting?]