Thank You Doctor Episode 4 Recap
> Thank You Doctor Recap
Xiao Yan observed that the hospital's emergency department entrance was configured as a one-way street with large stone pillars, forcing ambulances and patients to take a lengthy detour. She proposed to Director Jiang Zhongjing that these pillars be removed to allow quicker access for emergency cases. She emphasized that for patients suffering from conditions like sudden cardiac arrest or major bleeding, every minute saved could be the difference between life and death.
Jiang Zhongjing agreed with her reasoning and instructed Lu Ping'an to arrange for the removal of the stone barriers, stating he would handle the necessary approvals. Later, Xiao Yan attended to Dong Dong, a middle school student who had accidentally fallen and cut his forehead on a road curb. After a quick bandage, a CT scan of his brain showed no abnormalities, confirming it was just a minor external injury.
However, Dong Dong's father insisted on admitting his son to the EICU, fearing infection or internal bleeding, and stressed that they were willing to pay any cost for premium care. Xiao Yan explained that the EICU was reserved for critically ill patients and not suitable for Dong Dong's minor injury, also noting it would be detrimental to his recovery to be among severe cases. When Dong Dong's father grew agitated and threatened to complain, Lu Ping'an stepped in.
He calmly explained the differences between a traditional ICU, which is fully enclosed and machine-dependent, and the EICU, which is semi-open and designed for non-surgical critical patients. As he guided the family through the EICU, he subtly led them past a severely ill patient who was vomiting. Dong Dong, scared by the sight, declared he wouldn't stay in such a place and quickly left with his parents.
Xiao Yan, observing the scene, realized Lu Ping'an's clever strategy to deter unnecessary admissions and expressed her admiration. Lu Ping'an explained that the emergency department often reveals the rawest aspects of human nature, and sometimes, a tactful, indirect approach is more effective than direct confrontation to manage such situations and protect vital resources. The emergency department was frequently overwhelmed with long queues.
Xiao Yan proposed to Lu Ping'an a more efficient triage system: separating general emergency patients from critically ill ones. She suggested designating a staff member solely for directing critical patients directly to the emergency room, bypassing the standard registration process, as these patients could not afford to wait. Although Lu Ping'an initially questioned the feasibility due to space constraints, Xiao Yan insisted that the ER was a "battlefield" where every minute of delay could cost a life.
With Jiang Shan's encouragement, Lu Ping'an agreed to implement Xiao Yan’s proposed standardized procedure once it was formally approved and released by the hospital. Meanwhile, a 21-year-old university student, who had collapsed during a basketball game, was rushed to Tongshan Hospital's emergency department. His heart rate was 168 and blood pressure was 72/41. Bai Shu immediately responded, initially suspecting supraventricular tachycardia.
However, the patient's low blood oxygen saturation of 85% despite oxygen therapy, coupled with his prolonged unconsciousness of over an hour, led Bai Shu to doubt his initial diagnosis. Xu Yiran searched for any history of asthma or recent flu. The patient was transferred to the EICU for observation, and a bedside chest X-ray was arranged, showing no pneumothorax but patchy shadows on the right lung.
Tang Hua then intervened with a sarcastic remark, questioning why they hadn't considered foreign body aspiration. Upon investigation with a bronchoscope, a piece of chewing gum was indeed found in the patient's throat. Xu Yiran, surprised by how they had overcomplicated such a simple issue, realized that Tang Hua's timely suggestion was actually Xiao Yan's correct assessment.
Xiao Yan later explained that observing a sports field's trash cans for gum wrappers would reveal how common it is for athletes to chew gum during games, emphasizing the importance of considering the patient's lifestyle beyond just symptoms. Bai Shu, however, remained dismissive of Xiao Yan's insight, arguing that the source of the correct diagnosis was irrelevant. After work, Jiang Shan found Lu Ping'an studying Xiao Yan's newly drafted procedural guidelines.
Jiang Shan encouraged Lu Ping'an not to feel pressured by Xiao Yan and Bai Shu's perceived superior skills. Lu Ping'an confessed that after two decades in the hospital, his own career advancement was limited. He now aspired only to ensure the smooth and safe operation of the Emergency Department and EICU.
He recognized Xiao Yan's vision and international experience, appreciating her insights, which even inspired him to adopt a family visiting policy for the EICU, believing that family support significantly boosts a patient's will to live. Later, Xu Yiran and Zheng Yajie tried to persuade Bai Shu to join them for dinner and unwind, but he refused, explaining he needed to return home to Little Guang.
At home, Little Guang, Bai Shu's adopted son, observed Bai Shu venting his frustration by playing video games. Little Guang revealed that he regularly contacted Xu Yiran to monitor Bai Shu’s performance at the hospital, worried that Bai Shu might become disheartened and give up. He affectionately encouraged Bai Shu, expressing confidence that he would eventually return to the Cardiac Surgery Department.
Bai Shu then boasted about his own academic prowess, questioning why Little Guang didn't resemble him in that regard. Little Guang retorted that Uncle Xu had told him Bai Shu was short and untalented in his youth, and thus relied on studying to gain attention. Bai Shu, irritated, warned Little Guang not to contact Xu Yiran again, but Little Guang insisted he was only trying to maintain Bai Shu's friendships.
The next day, eight-year-old Yu Ming Ming, suffering from uremia, was brought to the emergency department by her father, Yu Jian Guo, and her aunt, after falling unconscious with a blood pressure of 70/40. Xiao Yan quickly diagnosed renal encephalopathy and ordered immediate blood and biochemical tests. During the examination, Yu Ming Ming suddenly went into ventricular fibrillation. Xiao Yan promptly initiated resuscitation and defibrillation. After intense efforts by the medical team, Yu Ming Ming regained consciousness.
Xiao Yan arranged for her transfer to the EICU for hemodialysis. Yu Ming Ming, being a very mature child, expressed reluctance to undergo further expensive treatments, fearing the financial burden on her father. However, Yu Jian Guo insisted he had sufficient funds and urged her to accept the necessary care. Xiao Yan observed this exchange with concern. Bai Shu maintained his aloof and arrogant demeanor, often retreating to his office to make coffee.
Lu Ping'an expressed his exasperation over Bai Shu's behavior, but Jiang Shan gently reminded him of Bai Shu's talents and suggested that the EICU, in its nascent stage, could benefit from such skilled personnel. She likened Bai Shu to a "wild horse" that Jiang Zhongjing trusted Lu Ping'an to tame.
Meanwhile, Xu Yiran lectured Chen Zhi, a new PhD graduate, for his overly theoretical approach and poor record-keeping, stressing the need for quick and decisive judgment in emergency situations, likening the ER to a battlefield against death. Chen Zhi, visibly frustrated, retorted that Xu Yiran was bothering him endlessly.
Bai Shu, listening in, added his own sarcastic commentary, telling Chen Zhi that his past misdiagnosis of meningococcal meningitis as common diarrhea meant his level would likely remain similar to Lu Ping'an's. He advised Chen Zhi to learn from Head Nurse Jiang Shan, emphasizing that practical experience and quick thinking were far more valuable than academic theories in the fast-paced emergency environment, suggesting that an inability to adapt quickly would make him better suited for a less demanding department.
Chen Zhi, though initially discouraged, expressed determination to learn. Bai Shu later mocked Xu Yiran for "acting tired" from pretending to be normal. A construction worker named Lao Zhang was brought in after being hit by a car, sustaining a minor head wound. Xu Yiran began preparations to stitch the wound, but Lao Zhang, who claimed to be feeling unwell, and his foreman stated they had no money and had to wait for their boss.
Xiao Yan, however, noticed a small amount of blood leaking from Lao Zhang's ear, a condition called otorrhea. Suspecting a more serious internal injury, possibly intracranial hemorrhage, despite the foreman's assurances that it was minor, she insisted on further examination. Lao Zhang then suddenly collapsed. Without hesitation, Xiao Yan initiated emergency treatment and promptly opened a "Green Channel" for immediate CT and MRI scans.
The scans confirmed extensive intracranial hemorrhage, and with Lao Zhang's consciousness deteriorating, Xiao Yan decided to perform an emergency craniotomy herself due to the urgency. Xu Yiran expressed profound gratitude to Xiao Yan for saving his patient, acknowledging her "Doctor's Benevolent Heart" and how she taught him to look beyond superficial injuries to detect critical conditions.
He noted that the foreman who initially tried to prevent further exams had panicked, and Lu Ping'an had not hesitated to activate the Green Channel. Bai Shu, seemingly annoyed by Xu Yiran’s praises and the idea that Xiao Yan was his "idol," quickly left the scene.
Xiao Yan carefully reviewed Yu Ming Ming’s medical records and was informed by Tang Hua that Yu Jian Guo had not only failed to bring his daughter for regular dialysis treatments but also hadn't undergone compatibility testing for a kidney transplant. Puzzled by his actions, Xiao Yan confronted Yu Jian Guo. Yu Jian Guo admitted that he sometimes skipped dialysis sessions due to the cost and his perception that Ming Ming wasn't always suffering intensely.
Xiao Yan explained that his inconsistent adherence to dialysis had resulted in irreversible damage to Yu Ming Ming's multiple organs, making a kidney transplant no longer a viable option. Yu Jian Guo was utterly shocked and struggled to accept the devastating news, insisting that local doctors had assured him a transplant was possible with a suitable match. He dismissed Xiao Yan, retorted sharply that it was his private matter and none of her concern, and walked away.
Later, while sharing a meal with Yu Ming Ming, Yu Jian Guo concealed the truth, telling his daughter that the doctor had simply advised him to take good care of her. In the bustling emergency department, a woman loudly complained about the slow service and demanded immediate attention for her headache, attempting to cut in line. The woman, insulted by being called 'Auntie' or 'Big Ma', angrily demanded to know who was calling her that.
Bai Shu, observing the chaotic scene, noticed a young man clutching his abdomen and sweating profusely. Recognizing the signs of distress, Bai Shu immediately bypassed the complaining woman, activated the "Green Channel," and escorted the young man for an urgent examination. He instructed a nurse to record the disruptive woman's behavior, warning her that his phone was worth 38,000 yuan, urging her to consider the consequences before attempting to snatch it.
After a quick physical examination, Bai Shu suspected a ruptured spleen, a diagnosis supported by the patient's history of being hit in the stomach by a bicycle handlebar the previous day. He promptly ordered a CT scan. The CT scan confirmed Bai Shu's suspicion: the patient indeed had a ruptured spleen, with his hemoglobin levels critically low at six grams.
Bai Shu immediately ordered a blood transfusion, arranged for his admission to the EICU, and contacted the Hepatobiliary Surgery Department for an urgent consultation. The patient's grateful family thanked Bai Shu for his swift intervention. Chen Zhi, impressed by Bai Shu's ability to identify such a critical patient amid the crowd, asked for his secret. True to his character, Bai Shu simply advised Chen Zhi to thoroughly review all his medical textbooks before asking such questions again.
