(Thanks to the encouragement from Nickname Doesn't Matter?, Master Fourteen, Little Demon God's Tentacle, Book Friend 20180728135128618, Zi Xing 87, Always Drunk, Empty Lonely Cold 671112, Fever Honest, Book Friend 161126123936905, Lang Ru Tie 83, Nina Selina for the monthly tickets)

"Teacher Liu, this is the urine bag we replaced less than half an hour ago. The volume isn't much, and the urine color has darkened again."

Leading Liu Banxia to the ward, Miao Rui said.

Liu Banxia leaned over and took a close look at the urine bag. Indeed, the urine color was darker than when they first started draining.

"After dialysis, the urine color had returned to normal, and we have been adjusting the electrolytes with fluids. But now the drainage volume has suddenly decreased," Miao Rui added.

"There's no other choice, send to the ICU. The equipment we have here isn't enough," Liu Banxia said. 𝚏𝐫𝚎𝗲𝕨𝐞𝐛𝕟𝚘𝐯𝚎𝗹.𝕔𝐨𝗺

"Doctor, didn't you say it was under control?" the patient's father asked anxiously upon arrival.

"The situation has changed, and it's beyond what we can manage in the ward," Liu Banxia patiently explained.

The patient's parents gave him a glance and nodded.

Even though they knew that going to the ICU would be more expensive, how could they refuse when it was about saving their son's life?

"The situation is a bit tricky, leave it to us."

Upon arriving at the ICU, Zhang Zhiyuan, after briefly understanding the situation, said.

"Ah... it's my fault. I should have sent him directly to ICU then. At the time, seeing the dialysis was effective, I thought adjusting the electrolytes would suffice," Liu Banxia said.

"That's quite normal. Even mild cases of rhabdomyolysis can become very complicated. Now, please bring me all the data you've collected in the ward, including drainage records. Do you have them?" Zhang Zhiyuan asked.

"Teacher Zhang, we have everything saved, just haven't had time to enter them into the medical records," Miao Rui quickly responded.

Zhang Zhiyuan nodded with satisfaction, "The people Banxia trained are reliable. Leave it to us to handle."

Liu Banxia and Miao Rui stepped aside, the subsequent work now in the hands of Zhang Zhiyuan and his team.

As he said, ICU is like special forces. They possess not only specialized knowledge but also advanced equipment.

That's why ICU doctors are hard to recruit; it's not a role just anyone can take. Interns can be trained appropriately, but if you're at the attending physician level, you must have real skills.

Liu Banxia has the system's backing and reacts quickly. But while he is skilled in surgery, he acknowledges his limitations in adjusting for such conditions.

He can interpret big data but is not equipped for the nuanced adjustments ICU staff undertake. They consider everything holistically before combining medications.

"Teacher Liu, what do you think might be the cause?" Miao Rui softly inquired.

"Sigh... I'm not quite sure now. Everything seemed to be improving, and it was only mild rhabdomyolysis. How did it escalate?" Liu Banxia sighed.

Miao Rui dared not speak again, sensing the self-blame in Liu Banxia's tone.

Liu Banxia glanced at the time; it was 1:42 in the morning.

Based on the timeline, the patient should have completed dialysis before midnight, meaning it took less than two hours for the condition to change.

He racked his brain, trying to figure out what he might have missed but couldn't come up with an answer.

Considering the patient's current state, it felt like there was more to it than just rhabdomyolysis. Perhaps there's another underlying condition that, combined, could be affecting the patient's condition.

"Miao Rui, did you talk to the patient during dialysis?" Liu Banxia asked.

Miao Rui shook his head, "The patient was very tired. We only communicated with the parents. But the patient lives in the city, and his parents don't know him well."

"During festivals, the patient often drinks heavily at home but never to this extent. Liu Yiqing and I have checked with his friends, now they can't even remember what dishes were ordered."

This was a key reason why Liu Banxia didn't ask too much initially; those heavily intoxicated can have muddled memories.

For someone that drunk to think of going to the hospital for detox is already quite remarkable.

The two waited there, nearly an hour until Zhang Zhiyuan came over.

"How is it?" Liu Banxia asked.

"It's mostly stabilized, the exact cause is still unclear," Zhang Zhiyuan said.

"Do you think it's another condition interfering?" Liu Banxia asked.

"I feel that if it were only rhabdomyolysis, even with complications, it wouldn't be this severe. The dialysis indicators were good at the time."

"It might be related to his myocardial hypertrophy, and we also noticed just now that his blood sugar seems quite low, doesn't it?"

"We observed this downstairs as well, but it seemed like a stress reaction from excessive drinking," Liu Banxia said.

"And apparently, from what their drinking buddies told us, during their gathering, they didn't really eat much food, they just kept drinking."

"That's not right either. When we supplemented with fluids downstairs, we also used glucose. Even if it stimulated a large secretion of insulin, it should have stabilized by now, right?"

"I'll keep tracking this situation. At the very least, the drainage volume has returned to normal," Zhang Zhiyuan said.

"Thanks for your hard work. We almost made a big mistake," Liu Banxia said with a bitter smile.

"Don't think you have to shoulder everything. Honestly, you might not have as much ability as you believe," Zhang Zhiyuan replied.

"I took a brief look at your records just now. Even if it had been sent to the ICU, we would've handled it about the same way."

"A lot of the times, that's how it is, you just deal with things as they come. The human body is so mysterious, who can confidently say they can diagnose it all perfectly? We'll continue to monitor the data, and I'll communicate with you if there are any significant changes."

Liu Banxia nodded. Right now, this was the only way.

The ICU is the last line of defense. If the ICU can't handle it, the truth may only be clear after an autopsy.

After walking out, he explained the situation to the patient's parents waiting outside.

They were quite relieved that their son's condition had stabilized again. Liu Banxia, however, felt a bit heavy-hearted, as he felt a sense of powerlessness with this patient.

This was the first time in his long medical practice that he had felt such defeat.

"You should take a break too; you have patients to see tomorrow," Liu Banxia said on the way back.

"The situation is stable?" Wang Chao asked as he emerged from the lounge.

Liu Banxia nodded, "The ICU held the line, but it's unclear if there will be changes. Don't dwell on it, it's already in the ICU's hands; we won't be able to do much more. Don't let it affect tomorrow's consultations."

"You should catch some sleep too. You have to be with Sister Wang tomorrow, right? Leaders from the hospital and the city will be there; you'll need to be alert," Wang Chao said, yawning.

Liu Banxia patted him on the shoulder and returned to the lounge on the first floor.

He did want to sleep, but it wasn't so easy.

His emotions were complex, tangled, and uncomfortable. He had felt this way before, but only slightly; now, the feeling was intense.

In short, it was what people commonly called "anxiety."

He felt an impulse that if there were a punching bag, he'd like to hit and kick it until he exhausted his pent-up energy.

He knew there might be some psychological disturbance affecting him recently. But what exactly was causing it, he couldn't quite pinpoint.

Even when Qin Hai bullied him in the past, it never troubled him as much as this.

It can't be early menopause, he was still young.

Logically, he should be thriving now. He had a beautiful wife, who was pregnant with their twins. His career was on the rise, soon to become the associate director of the emergency center.

Even if he didn't care about promotions or pay raises, having the title of associate director was quite prestigious.

It would grant him more surgical privileges without waiting for approvals, which were all positives. Why was he so unsettled?

Where exactly was the problem? Despite racking his brains, he couldn't figure anything out.

A healer cannot heal themselves; it's no joke. He could objectively treat every patient, but when it came to himself, he would unconsciously avoid some truths.

He rubbed his face vigorously. Wang Chao mentioned that both hospital and city leaders would attend the condolence meeting tomorrow. It was due to Sister Wang's husband's connections, previously unnoticed.

In such a setting, he really couldn't afford to mess up.

It wasn't about his future; anyone would disapprove if he kept nodding off at the event.

But that's how things were. The more you tried to sleep, the more restless you felt, and the harder it was to fall asleep.

Then Liu Banxia realized he had insomnia.

For someone frequently on hospital duty, insomnia didn't happen often. He had been a resident for so long without experiencing this.

Even when he wasn't sleepy, he could usually fall asleep after tossing around in bed for a while. That's a doctor's passive skill, essential to avoid exhaustion at work.

He pondered over the patient's condition. Currently, the symptoms were recurring illness and low blood sugar. Could the low blood sugar be causing the symptom recurrence?

What happened to the glucose from the IV fluids? Even if the insulin secretion was intermittently high, it shouldn't continue at such low levels.

Was the patient naturally hypoglycemic? If so, they'd have to arrange endocrine tests the next day.

Thinking and thinking, slowly, he fell asleep.