Chapter 16 — The One Who Keeps The Venom Saves People

The first sunlight of the morning finally penetrated the thick layer of rain clouds, casting a pale streak of light through the emergency room window at nearly eight o'clock. Du hasn't left the hospital yet, even though sleepiness has pulled her eyelids heavy, only her third cup of black coffee in the morning keeps her awake.

The latest kidney function test results appeared on the computer screen, and Thu, who had just finished reading them, frowned slightly.

"Ms. Du, the baby's creatinine index has increased significantly compared to six hours ago." She said, her voice clearly showing concern. "Urine output has also decreased significantly in the last three hours, less than one ml per kilogram of body weight per hour."

Du walked closer and looked at the numbers. The initial feeling of relief now gave way to a new worry. "Acute kidney injury, possibly due to the breakdown products of red blood cells and muscle, accumulating in the blood for a long time before being completely neutralized by the venom. This is a common complication after severe and prolonged snake bites."

"Our district hospital doesn't have a dialysis machine." Thu said, her voice heavy. "If this condition progresses to true acute kidney failure, you must transfer the baby to higher level care."

"Had to cross the flooded street again." Du said, not a question, just a fact she just realized immediately.

They were both silent for a moment, understanding what that meant—another trip, another risk, while Nhi's body had gone through so much in less than twenty-four hours.

"Does the provincial hospital have a dialysis machine?" Du asked, even though he already guessed the answer.

"Yes, but the road to get there is twice as far as the district hospital, and the worst flooded part has not receded yet." Thu shook her head, without leaving the keyboard, continuing to update orders. "Besides, moving a pediatric patient whose hemodynamic condition is not completely stable through a bumpy, flooded road that lasts for many hours, that itself carries significant risks."

"Do I have any other options?" Du asked, even though in her heart she had already begun to find the answer herself.

"There is a private medical center in town fifteen kilometers from here that has an emergency dialysis machine, but they mainly serve adults; I'm not sure if they have experience with pediatric patients." Thu said, her voice hesitant. "Besides, the cost there is much higher than the child's family can afford."

"Let's think about it later, if we really need it." Du decided. "For now, I'll try my best not to have to go to that step."

"Give your baby fluids carefully, closely monitor the balance of fluids in and out, avoid circulatory overload." Du said, try to find a plan to delay the need for hospital transfer if possible. "If creatinine continues to increase over the next three hours with no signs of improvement, I have to consider switching urgently."

Thu nodded, began to adjust the medical orders, and called the nurse to make the necessary changes. Du stood watching, her hands clenched on the armrests, the feeling of helplessness once again crept into her heart - this time not because of a lack of serum, but because of a lack of basic medical equipment that a poor district hospital could not afford to equip.

She walked out, called Thanh, and reported the latest situation.

"If you have to be transferred to the hospital and the road is still flooded, what will you do?" Thanh asked, his voice unable to hide his concern.

"I don't know yet." Du admitted honestly. "But if that time comes, we will have to find a way, no matter how flooded the road is."

Two hours later, the next test results appeared, and this time, Du and Thu stood side by side looking at the screen, holding their breath.

Creatinine index did not increase further. The amount of urine begins to increase slightly, although it is still low compared to normal.

"Seems to be stabilizing." Thu said, her voice not daring to confirm for sure. "But more monitoring is still needed."

"Careful fluid administration plus coagulation plasma probably helped reduce the burden on the kidneys." Du analyzed, although in his heart he still did not dare to breathe a complete sigh of relief. "But we must not be subjective, this situation may fluctuate up and down in the next few days before stabilizing completely."

Du's phone vibrated, Khang's number. She picked up the phone, a bit surprised because she didn't think he would call her directly.

"Miss Du, I'm calling to ask about the patient's condition." Khang's voice rang out, sounding much less tense than last night's call. "Miss Tram reported that the plasma had been used. I want to know more."

"Blood clotting has improved, but the baby is showing signs of acute kidney injury, possibly due to complications that persisted before the venom was neutralized." Du reported briefly. "We are trying to treat it with careful intravenous fluids first, hoping we won't need to transfer to the hospital."

"If you need to move, just let me know right away." Khang said, his voice decisive. "I will arrange for a fully equipped ambulance, even if I have to send one from the province to pick me up halfway."

"Thank you, doctor." Du said, her voice a bit surprised at the obvious change in attitude compared to the initial rejection call. "I understand your position last night. There's nothing to feel guilty about."

"I'm still guilty." Khang admitted in a rare sincere voice. "But last night I also learned one thing - sometimes rigid processes just need a different perspective to find the way, as Ms. Tram showed me. Maybe we should sit down and discuss more carefully about coordination between parties in the region, so that we don't have to race against time like this every time there is an incident."

"I'd really like to discuss that, doctor." Du said, another ray of hope, unrelated to baby Nhi, flashed in her heart. "But until everything here settles down."

"Okay, just focus on taking care of the baby first." Khang said. "When you're free, call me."

She turned back to look into the room, where baby Nhi was still lying there, the IV and monitoring lines were still tangled around her small body, but her chest was still rising and falling in a $1 breathing rhythm - the breathing of a life regaining its footing after an unsteady night on the line between life and death.

In the hallway, Luc and Bong finally sat down, leaning against each other, their eyes dark from insomnia but no longer panicked like in the first hours. Bong held the small pink plastic slipper in her hand, this time no longer squeezing it with anxiety, but just gently caressing it as a souvenir of a night when her family almost lost the most precious thing.

Du stood looking at that scene through the glass window for a while, then turned to Khiem who was sitting dozing on a plastic chair nearby, sleepiness finally winning after a long, restless night.

"Go back to camp and rest." She said, gently shaking his shoulder awake. "I'll stay a few more hours to monitor. I'll report back later."

"You need to rest too." Khiem mumbled, his eyes still closed due to sleepiness.

"I can rest when I'm sure the baby is completely fine." Du replied in a rare gentle voice. "Go home, tell Mr. Thanh the situation for me."

Khiem nodded, stood up, and staggered a few steps before fully waking up. He stopped at the door, turned to look at Du again. "Miss Du, thank you for letting me come along last night. I think I learned more than the previous months of training combined."

"I'm the one thanking you." Du smiled, the first real smile appearing on her face since the beginning of the night. "If it weren't for you to steady my mind when I lost my footing in the middle of the water, I would probably be lying in another hospital right now, not standing here."

Khiem smiled wryly, scratched his head, then walked out of the hallway, his gait still wobbly due to lack of sleep but somehow more steadfast than the young man who timidly stepped onto the boat for the first time last night.

Du turned back to look at the hospital room again, then walked over to where Luc and Bong were sitting. "You can visit the baby for a bit, but just stand and watch, don't touch the IV lines."

Bong stood up immediately, his eyes bright even though there were still tears. "Really, sister? We can visit our child now?"

"Okay, let's go in quietly." Du nodded and stood aside to make way.

The couple entered the room, tiptoeing as if afraid of disturbing their daughter's sleep. They stood next to the hospital bed and looked at their child for a long time without saying anything. Bong reached out and gently touched Nhi's small hand, carefully staying away from the IV line, and in that moment, tears fell again, but this time they were completely different tears - no longer carrying fear, but only overwhelming relief.

Du stood outside the door observing the scene, a warm feeling spreading in her heart even though her body was exhausted from exhaustion. This is the reason she chose this profession, even though every time she faces it, she still has to struggle with her own fear, a struggle that will probably last for the rest of her professional life.