Lu Junran had a night of hazy, restless dreams.
In his dreams, his parents argued endlessly. Someone shattered a glass—he couldn't tell who threw it first—producing a sharp, piercing crack: "I regret marrying you! You have no sense of responsibility at all!"
The sounds of the dream and reality intermingled, forcing Lu Junran to open his eyes.
The couple upstairs had been fighting for nearly a month now. Their quarrels seeped through the gaps in the central air conditioning, and Lu Junran had become intimately familiar with their domestic affairs.
The couple had just had a baby, but the husband never came home. Every night it was either a business dinner or a gathering with friends, leaving his newly postpartum wife alone with her mother and the confinement nanny.
The woman's voice was hysterical, and against that backdrop, her husband sounded eerily calm.
Lu Junran had no interest in other people's family matters. He rummaged through the drawer of his nightstand, pulled out a pair of noise-canceling headphones, put them on, and tried to drift back to sleep.
This time he slept until morning. When Lu Junran woke again, he had already forgotten the contents of his dreams, but he felt an emptiness in his chest. He fumbled for his phone by his pillow, and his first instinct was to check his unread WeChat messages.
There were two from his junior sister: 【Senior Brother, are you okay?】
【Senior Brother, maybe you should take a day off. Your health comes first.]
And so, Senior Brother's empty heart was filled by his junior sister's concern.
Unfortunately, Lu Junran couldn't see his own expression, unaware of how radiantly he was smiling.
【I'm fine, I've already recovered. No need to take leave.]
Lu Junran wasn't lying. He was no longer weighed down by worries—he had only one thing left on his mind. A clear goal, ironically, brought a sense of calm to his heart.
Ye Wushu had initially assumed her senior brother was just putting on a brave face. But at the morning meeting, she saw his rosy complexion and couldn't help but marvel inwardly—surgeons really did have formidable constitutions.
Little did she know, that was the "glow" of seeing the one you love.
Her senior brother had brought her breakfast: two ciabatta rolls the size of fists, a rice ball the size of one fist, and a large hot latte.
Ye Wushu thought her senior brother was a genuinely sincere person—even the food he brought was that substantial.
By the time the morning meeting ended, Ye Wushu was already stuffed. She hid in a corner, forcing down the last bite of her rice ball like some small creature storing food in its cheek pouches, and let out a quiet burp.
Lu Junran caught the whole scene, and his mood brightened considerably. Strange as it was, he knew he liked his junior sister, but he had no urge to kiss her or any thought of defiling her.
He only wanted to feed her, to watch her eat until her belly was round and full, then sit back in her chair with a satisfied sigh.
At that moment, he felt his own heart was full too.
The morning meeting ended, and everyone filed out one by one to do their rounds. Lu Junran deliberately slowed his pace so that Ye Wushu would be just half a step away from him.
"Senior Brother—" Ye Wushu said, "Thank you for the breakfast, but it was really too much. Don't buy so much next time."
Lu Junran readily agreed: "Then I'll buy less tomorrow. What do you want to eat tomorrow?"
"Huh?" Ye Wushu sensed something off. "No, no—Senior Brother, you don't need to bring me breakfast anymore. I live in the hospital dormitory, so I can just go to the cafeteria in the morning."
The group stopped at the first patient room. Afraid of drawing attention, Ye Wushu immediately fell silent, losing her chance to continue "debating" with her senior brother.
"This patient…" Wu Yue said, "There's nothing particularly unusual about the condition, and all the indicators are improving. However, the family is quite concerned about costs, so you must communicate with them about anything we use."
A good doctor needs to care not only about the patient's basic condition, the severity of the illness, and the treatment plan, but also pay close attention to the family's willingness to treat.
This is something that was never taught in textbooks.
Some families say they want to treat the patient, but in reality, that's not the case. They're just putting on a show in front of the patient, displaying their filial piety. When it actually comes time to spend money, they jump out and make a fuss—objecting to this, objecting to that.
Their meaning is also simple—spend as little money as possible while still curing the person.
When dealing with such families, you can't be fooled by appearances. They seem extremely polite, saying "Hello, doctor" and "We trust the doctors completely" at every turn, but in the end, they're the same ones who go to the medical affairs office to cause trouble.
"This is an old patient; she can be transferred to the rehabilitation hospital in the next couple of days," Wu Yue said. As she spoke, the patient struggled to sit up in bed and gave her a thumbs up.
The family member sitting nearby smiled and explained, "We're all extremely grateful to Chief Physician Cong and Dr. Wu for their help. If it weren't for you, my wife wouldn't have regained consciousness."
The ICU has sent many people off, and it has also brought hope to many families. Ye Wushu looked at the grateful eyes of the patient and family—so trusting and unreserved.
A scholar will die for one who appreciates him, and when doctors encounter families willing to entrust their lives to them, they too are willing to stake their reputation on a try. But the ungrateful ones who came before have completely blocked that path.
The ICU is a department independent of surgery and internal medicine, and its style is closer to that of an internal medicine department—primarily focused on medication. The knowledge of drug interactions is vast and profound; as long as they are properly coordinated, a critically ill patient's life can be saved.
Ye Wushu loved using medication, just as Lu Junran loved the feeling of holding a scalpel. She was like a sponge desperately absorbing water, studying and pondering the medication habits of different attending physicians in the ICU.
Take Dr. Ni Li, for example—he was originally a general surgeon, so his approach to medication was somewhat rough. Dr. Geng Jie was originally from neurology, so she was quite familiar with neurological drugs. Dr. Deng Lingxiu was originally from anesthesiology, so she was very professional in managing ventilators for intubated patients. Dr. Wu Yue was originally from the emergency department, so she was very skilled at communicating with various departments…
During rounds, Ye Wushu overheard Dr. Wu Yue on the phone:
"Hey, hey, okay, okay, I'll try my best to arrange it. The beds are pretty tight today."
"Director He, you're occupying too many beds right now. If you want to admit new patients, at least transfer a few out first, right?"
"Director Li, are all of your department's patients coming today?"
Because she was standing close, Ye Wushu heard the delighted voice on the other end of the line: "Can they all come? Can they all come?"
At the same time, Ye Wushu saw the exasperated expression on Dr. Wu Yue's face.
"They can't all come, they can't all come! There are so many people on the waiting list!"
"Then prioritize that 82-year-old. He has sepsis, and the anesthesiology department requires him to have a ventilator post-surgery, so he can only go to your unit."
After hanging up the phone, Wu Yue let out a long, deep breath: "Ten empty beds, but fifteen patients need to come in. How are we supposed to handle this?"
After a moment, Ye Wushu saw Teacher Wu Yue, who had been wearing a worried expression just moments ago, fluttering over like a happy bird. "I'm off after my night shift today—I'll leave the bed adjustment to you!"
Me?
Ye Wushu pointed at herself, utterly stunned. Since when did she have that much authority?
It wasn't until Wu Yue passed her by and handed the pager to Geng Jie that Ye Wushu's heart settled back down.
Today was an extremely chaotic day—there were many patients being transferred between departments, discharged, and newly admitted. Even though Ye Wushu was already a "seasoned helper," she still got her medical orders rejected by the nurses several times.
"Don't prescribe from the general pharmacy—use the special one!"
"You prescribed the wrong insulin!"
"Rotating doctors! Can you refresh the system before entering orders? Bed 10 has already been moved to Bed 2!"
"Rotating doctors!" The head nurse stormed furiously up to Ye Wushu and Lu Junran. "Who just wrote orders for Bed 28? You wrote them for the wrong patient! I was ordering for the new patient, but you put them on the old one—that patient's already been moved upstairs! The ward upstairs just called asking why we're writing orders all wrong!"
Lu Junran was about to bravely step forward and admit his "mistake."
But his junior female disciple was faster. "Sorry, teacher, we'll be more careful next time. There are just way too many patients today."
Ye Wushu had the face of an adorable girl, with eyes as clear as two springs of water. Her attitude was sincere and earnest, and the head nurse's anger dissipated by half. "Alright, just be careful next time."
Ye Wushu's charm didn't just melt the head nurse's heart.
She turned to her senior fellow disciple and shared her wisdom. "When you work in clinical settings, as long as you keep a sincere attitude, most teachers are more than willing to teach you."
Her senior was distracted, as if just waking from a dream. He nodded along in agreement, but in truth, he hadn't absorbed a single word.
Putting aside the fact that he liked his junior fellow disciple, she was an excellent "work partner."" Lu Junran hadn't rotated through other departments, but he'd done group projects before—the so-called group project meant 2-3 people doing the work of 10-plus, with everyone trying to slack off and do less.
Before coming to the ICU, Lu Junran had already decided to be a "slacker" here. Those who could work would never run out of work, so he chose to do a half-hearted job.
But his junior fellow apprentice wasn't afraid of that. She was diligent and eager to learn, spinning around between patients like a little top every day. She had a small notebook where she recorded each patient's condition changes daily.
"Senior Brother!" I just went to check on Bed 6, and I noticed Bed 8 was playing on his phone!"
"So?"
"That means he's getting better! A few days ago, he wasn't playing on his phone at all!" Having the mood to play on one's phone is one of the effective indicators for judging a patient's recovery.
Because those who are truly severely ill or in discomfort have no mood to play on their phones.
Lu Junran sometimes couldn't even understand why Ye Wushu was so happy.
"Senior, I got the link for Bed 8's magnetic phone stand!""
Lu Junran: "…" He didn't understand. But he really liked how his junior female disciple chattered away telling him these things.
His junior female fellow disciple asked if he wanted one too. Lu Junran was about to decline, but on second thought, he realized it would match his junior sister's, so he immediately changed his answer.
At noon, they went to the cafeteria together. At mealtime, the cafeteria was packed—two stools could barely fit three people.
By now, they had a division of labor: Lu Junran would get the food, and Ye Wushu would save the seats.
Ye Wushu felt that they had forged a deep bond of camaraderie as battle comrades, while Lu Junran was reminded of that couple from their university days—always together, whether heading to class, the cafeteria, or the library.
His junior female fellow disciple sent him a list of what she wanted to eat on her phone, and he had already predicted her lunch choice: 【Two liang of thin noodles, with an extra serving of spicy pork and a fried egg, right?】】
Ye Wushu added sheepishly: 【Today I also want a glass of bayberry juice】
Besides the bayberry juice, Lu Junran also brought her a serving of fruit—he had spotted it for sale at the meal window earlier, placed alongside the soup, and had deliberately grabbed two portions.
Ye Wushu praised him without reservation: "Senior brother! You're so thoughtful!" Unfortunately, she had never been in a relationship and had no strategist to guide her, or she would have realized that what they were doing now was somewhat ambiguous—even a boyfriend and girlfriend going to the cafeteria together wouldn't be much different from this.
Ye Wushu didn't find her senior brother's "thoughtfulness" strange at all. From her perspective, her senior brother was simply a genuinely good person.
It was just that recently, her senior brother kept staring at her during meals, which made her wonder if she was smacking her lips while eating.
Startled, Ye Wushu slowed down her chewing and kept her mouth tightly shut to avoid making any impolite eating sounds.
But her senior brother still stared at her intently, and whenever she looked up, he would avert his gaze.
Ye Wushu couldn't take it anymore: "Senior brother, is there something wrong with the way I eat?"
Lu Junran thought he had been caught red-handed and panicked, not knowing what to do.
Ye Wushu addressed it directly: "Senior brother, if there's anything inappropriate about how I eat—like smacking my lips—you can tell me. It's fine, don't be shy."
Lu Junran felt his panic was completely unnecessary. He was silent for quite a while before finally saying: "No, nothing like that… I just… find that watching you eat makes my meal more appetizing."
His junior female fellow disciple fell silent too.
Ye Wushu's silence was deafening.
So her senior brother had been treating her like a mukbang streamer.
It took Ye Wushu only one second to accept this.
After finishing their meal and returning to the ICU, a big case came in—the emergency department was sending over a 15-year-old girl who had fallen into a coma, with a preliminary diagnosis of autoimmune encephalitis.
Autoimmune encephalopathy falls under neurology, but since the patient was comatose and had undergone a tracheotomy, she could only be admitted to the ICU, with a neurology consultation requested.
The family handed Ye Wushu a thick stack of medical history and relevant examination reports from previous hospital visits.
Ye Wushu began to regret drinking that glass of bayberry juice.
As everyone knew, neurology medical histories were the hardest to write.
Ye Wushu sat in front of the computer, frantically grabbing at her hair, and asked her superior: "Teacher Geng, did you switch to the ICU back then because you hated writing neurology medical histories?"
"No." Teacher Geng Jie could also crack dry jokes. "It's because neurology patients don't just have problems with their brains—they have problems everywhere. Unlike patients in other departments, who at least have healthy brains."
Ye Wushu then asked: "What about neurosurgery patients?"
"Neurosurgery…" Geng Jie said in a casual tone, "They only do the surgery. Once they're done cutting, they dump the patients on neurology or a rehab hospital."
After Geng Jie finished her joke, she turned serious. "Actually, neurology is a vast and complex discipline. Many of our teachers have spent their entire lives researching it, and in the end, they still can't fully grasp even their own specific areas of study. Take this autoimmune encephalitis, for example—we still can't completely understand it. The guidelines only state that it's a central nervous system autoimmune disease mediated by or associated with anti-neuronal antibodies."
Among those who chose internal medicine, those who picked neurology were undoubtedly both geniuses and warriors. Geng Jie realized she was of average aptitude and ultimately gave up on it.
"You two can start by writing up the medical history. While you're at it, I'll take this opportunity to give you both a mini lecture."
This was a teaching task that required photo documentation. Geng Jie asked a nurse to record videos and take photos, then put together a makeshift PowerPoint and began the lecture.
"Xiao Lu, why don't you present the basic case information for this patient?"
Ye Wushu quietly slipped over a medical history he had just written and printed out.
So Lu Junran read from it: "Patient, female, 15 years old, with disturbance of consciousness for 3 months. On 06-15, she began experiencing poor nighttime sleep with occasional mild delusions. On 06-20, she developed behavioral abnormalities accompanied by altered consciousness. She was seen at a local brain hospital and was given oral sedatives, after which her sleep improved. On 06-27 and 06-28, her behavioral abnormalities and altered consciousness worsened, and she was admitted to the psychiatric department of the local brain hospital… On 07-03, her cerebrospinal fluid tested positive for NMDAR antibodies (CSF NMDAR antibody titer 1:10; serum NMDAR antibody 1:100), and she was diagnosed with autoimmune encephalitis and transferred to the neurology department. On 07-04, she received a 500mg methylprednisolone pulse therapy. From 07-05 to 07-08, she received 500mg methylprednisolone plus 20g intravenous immunoglobulin pulse therapy…"
The local hospital's treatment had little effect. Later, the girl developed respiratory distress and a drop in pulse oximetry. She was first intubated, then underwent a tracheostomy, and received plasma exchange five times in total.
Her parents refused to give up and spent a considerable sum to transfer her to the most prestigious tertiary hospital in Haidu City.
The brain is the most mysterious organ in the human body. When other organs fail, you can try to "patch things up" with artificial organs or living donor transplants—but not the brain.
Moreover, the brain is fragile. It can develop problems under all sorts of triggers, and most of the mechanisms remain unknown. When doctors can't figure it out, they blame the "immune system." In fact, every system is like this—when all else fails, they say the immune system has "gone berserk."
Generally speaking, if you've run every test and still can't find a cause, nine times out of ten it's an immune issue.
Geng Jie nodded but still criticized Lu Junran: "Xiao Lu, even though you'll be a neurosurgeon in the future, that doesn't mean you can just focus on operating. You still need to master these basic skills and knowledge. You should learn more from Xiao Ye."
Geng Jie then asked: "So, what are the differential diagnoses for this disease? And how do you rule them out?"
Ye Wushu rattled off four in one breath: "Intracranial space-occupying lesions, intracranial hemorrhage, intracranial infection, and epilepsy. The first two can be ruled out with CT and MRI. Intracranial infections usually have a prodromal infection history, along with fever and headache, and there will also be abnormalities in CSF lymphocytes and protein. Epilepsy can be confirmed with an EEG—patients with epilepsy will show epileptiform discharges on their EEG."
The junior apprentice sister said everything she could think of, and Lu Junran cast a pleading look at her.
Ye Wushu thought for a moment, then sent him the answer on WeChat: 【Mitochondrial encephalomyopathy】
Lu Junran glanced quickly at the message on his watch and said, "Glandular encephalomyopathy!"
Geng Jie was puzzled. "What is glandular encephalomyopathy?" Could she have missed the latest clinical guidelines in neuroscience?
Lu Junran couldn't explain it—he didn't even know what mitochondrial encephalomyopathy was.
The field of neurology was too finely divided; one neurology professor couldn't even understand what another neurology professor was researching.
Ye Wushu had no choice but to bite the bullet and answer for him. "It's mitochondrial encephalomyopathy, usually caused by genetic defects that lead to mitochondrial metabolic enzyme deficiencies, resulting in impaired ATP synthesis and diseases caused by insufficient energy…"
Geng Jie gave Lu Junran a meaningful look.
"Teacher Geng, is this photo okay?" The nurse came over with her phone after they finished talking. "This one captured you and the two students, but it didn't get the PPT… This one! This one got everything—does this work?"
She swiped back and stopped at a photo where only Lu Junran and Ye Wushu appeared, and couldn't help but exclaim, "Teacher Geng, the rotating residents you got this month—the man is handsome and the woman is beautiful."
Lu Junran sat to the right and slightly behind Ye Wushu. He looked forward, as if watching the PPT, but it seemed more like he was tracing her silhouette with his peripheral vision.
Thump, thump—only Lu Junran knew what was in his heart.
Ye Wushu leaned over. "Teacher, you took such a great photo—the composition is beautiful!"
Using Ye Wushu's words as an excuse, Lu Junran asked the nurse for that photo.
"Alright, I'll AirDrop it to you." The nurse gave a knowing half-smile, as if she had already seen through his feelings.
"Okay, that's it for today's lesson. One last addition: for this patient, we'll do routine sedation and fluid replacement—those are the basics. Then we'll request consultations from neurology and psychiatry. The plan is to re-examine the cerebrospinal fluid, but exactly what to test for will depend on the neurology consultation's feedback. And whether to initiate immunotherapy later will also need to be discussed with the neurologist."
Geng Jie said, "Alright, it's about time. You can clock out now."
Lu Junran actually didn't want to leave, but his junior apprentice sister changed clothes in a flash and was already about to dash out the door with her backpack.
Ye Wushu nearly collided with an old man holding a wheelchair outside the door. Fortunately, she stopped in time—otherwise, the "grievance pay" the hospital gave her wouldn't have been enough to cover the damages.
"I'll just leave my stuff here with you for a bit…"
"Huh?" Ye Wushu looked helplessly toward the teacher who hadn't yet gone inside.
The nurse had already said impatiently, "No, we don't store things here. What if something gets lost?"
The old man was plainly dressed, but his eyes were like two burning coals—clearly not someone to be trifled with. He raised his voice. "Then what am I supposed to do? I can't afford a hotel! What's the harm in leaving my stuff here for a bit!"
Seeing that the nurse was alone and outmatched, Ye Wushu quickly chimed in, "Sir, hospital rules say nothing can be stored here. You should take it back!"
"How can I not put it here? What's wrong with putting it here for a while? Can't I just take it away tomorrow? I have nowhere else to put it!" The old man said, still trying to walk inside. "I have nowhere to stay either. Can't I just stay with her?"
Ye Wushu wanted to stop him, but Lu Junran beside him moved faster: "Stop right there!"
He was tall and imposing, which gave him a sense of pressure. Although the old man was sharp-tongued, he didn't dare to walk any further inside. "Then I want to go in! Why won't you let me in? Where's the logic in that? Fine, then we won't stay here—we're going home!"
Lu Junran sneered: "If you don't want to stay, that's fine. Then wait outside, and I'll notify the surgeon to discharge you, or what? How about that?"
Neurosurgery never tolerates patients like this. Every attending has a temper, and if you want to "throw a tantrum" or "be uncooperative" in the ward? Sorry, we won't operate—please check yourself out.
Want to file a complaint? Go ahead. The lead attendings of these assertive surgical departments have never feared complaints.
Ye Wushu quietly tugged at her senior's sleeve. "Brother, this isn't a neurosurgery patient—this is a general surgery patient."
Lu Junran was completely unbothered. "It's fine, no big deal." A general surgery patient? Then let them handle it themselves.
If a surgeon can't manage the patient's family, then he'd better quit, because difficult, unreasonable families like this are hardly rare in clinical practice.
Ye Wushu: 0-0