Chapter 162

162. Cat Hanyou (1)

I stared at the cat hanyou patient.

Do I need to insert a chest tube to drain blood and air? Should I surgically stop the bleeding from the punctured lung? How can we save this guy?

The lung has a hole, making breathing difficult. Ideally I’d check oxygen saturation, but it doesn’t look good.

No cyanosis yet, though.

“Patient, open your eyes!”

“Yes?”

“We’re going to drain the blood from your chest cavity. It might hurt a bit.”

“Eh, wait a second!”

I examined the arrow embedded in his side. Removing it carelessly could cause massive bleeding.

“Is it just an arrow, or does it have hooks on the back?”

“I don’t know- Ow!”

The patient let out a sharp cry of pain.

“Can’t you leave that alone?”

“It’s not something we can just ignore.”

“Ow! This really hurts!”

“Stay conscious for me now.”

I motioned to Amy, who grabbed the patient’s arm. His injured side seems too painful to move, so he’s trying to push me away with his other hand instead.

“Let me explain what we’ll do.”

“Can’t we skip this part?”

Not happening.

“Now, we’ll suture the wound. For the chest tube, we’ll find an appropriate spot, make an incision, and carefully insert it. Understand?”

“Aaah, alright…”

“Breathe, breathe. Stop talking.”

Carefully moving the arrow, it didn’t seem to have hooks. I began gently pulling it out.

Blood started flowing.

“Can I have some gauze please?”

The arrow came out with a metallic sound. Blood began spurting, so I turned my head. Time to stop the bleeding.

“Patient, we need to apply pressure.”

Taking the gauze from Amy, I pressed on the wound. We need to control the bleeding before suturing.

Pressing the gauze against the wound…

“Ow! Wait!”

“I apologize.”

There’s nothing to be done about it. We must stop the bleeding.

Amy fetched some saline solution, which we poured over the wound to clean away the blood.

I took out some lidocaine for local anesthesia, injecting a small amount around the wound. Lidocaine also helps constrict blood vessels, which should reduce bleeding.

Amy cleaned the area again.

“Can you breathe?”

“Maybe?”

“Breathe deeply. Before I put the bellows in your mouth.”

“Yes?”

“Breathe.”

“Yes.”

Looking around the ward…

“Nurse, we need to suture this immediately. Please hold the patient down!”

Feels like I’m running a yakuza operation. Spending all day restraining patients and performing torturous procedures.

Of course, it’s for their own good.

But if someone walked by, they might mistake this for torture.

With a punctured lung, you can barely scream properly. The patient was semi-hysterical, muttering incomprehensibly.

First, let’s start repairing the damage. Wearing sterilized gloves, I examined the wound. First I’ll suture the muscle layer inside the chest wall, then repair the skin.

Suturing everything at once could be dangerous.

“Hold still!”

“Don’t interfere.”

We don’t need too many stitches. The arrow wound is only about 5 cm long, so just a few stitches should suffice…

“If you keep moving, it’ll end up crooked.”

Finishing up.

***

The patient is breathing, and the wound is roughly stitched up. Let’s move to the next step.

We need to insert the chest tube immediately.

We need to drain the fluid from the lung so the patient can breathe properly. Though we have pill-form painkillers, given the coughing and bleeding, I’ll administer an IV instead.

After injecting a small amount of propofol into the patient’s vein, I prepared the scalpel. Now to find the right spot for the chest tube…

Counting the ribs… Between the fifth rib, cutting above the bone will allow us to insert the tube.

Quickly now.

There’s no time to waste.

Lifting the scalpel, I made an incision below the thoracic cavity, then inserted the pre-sterilized rubber tube. A dark red liquid flowed out like opening a faucet.

Confirming the tube was correctly placed, I sutured around it with silk thread to secure its position. Fortunately, the patient is slim.

So far, so good.

With obese patients, even inserting a chest tube can become major surgery. There’s a big difference between inserting 4 cm versus 8 cm deep.

I shook the patient awake.

“Can you breathe now?”

The patient didn’t respond, staring blankly without blinking despite still breathing.

***

What is this? While propofol can cause decreased consciousness, I didn’t expect this extreme reaction.

For a moment, I thought he had died.

Even using a small amount for pain management seemed to have this effect. Perhaps the cat hanyou’s internal system is different. I pondered briefly.

Something feels very off.

We helped the patient sit up on the bed.

Then I realized the issue.

“Ah, why isn’t the patient blinking?”

“Don’t know.”

“When did this start?”

“Not sure. They were fine earlier.”

Could it be the propofol?

It makes sense, but…

Fluid continued to drain from the chest tube.

“Let’s observe the situation for a few minutes. Check the patient’s breathing and pulse stability carefully.”

This is unsettling. Checking the patient’s pulse again, propofol shouldn’t cause hemodynamic instability. The pulse is normal.

Turning to Amy…

“Were they definitely blinking earlier?”

“Yes.”

“Let’s keep the corneas moist.”

Dipping clean gauze in saline, I wiped the cat hanyou patient’s eyes. If the cornea dries out, it could be serious.

***

Understanding the situation took some time.

Cats are different from humans.

Cats have faster metabolisms than humans and blink less often. I haven’t specifically studied cats, but assuming this is correct…

That’s why the propofol reaction was different. Assuming the patient retains some feline characteristics, they likely react more strongly and quickly to medications.

We carefully kept the patient’s eyes moist with wet gauze. Hopefully the corneas didn’t dry out.

That was close.

Don’t cats rarely blink?

Looking at Amy…

“My hypothesis is this.”

“What?”

“Cats hardly blink anyway, right? Maybe cat hanyous don’t need to blink as much as humans. Even in this frozen state.”

“That’s possible…”

Though we can’t be certain.

Since it’s our first cat hanyou patient.

I continued wiping the patient’s eyes with damp gauze. Humans wouldn’t completely stop blinking just from using anesthetic.

We could use naloxone to forcibly wake them, but there doesn’t seem to be any need. No apparent problems have arisen.

***

The nurses removed the blood-soaked bedding while Amy and I moved the patient to the examination room bed. Quite the struggle.

It took three people to move the patient to the examination room: one holding the feet, one holding the head, and one managing the chest tube container.

We finally succeeded after some effort. Amy sat the patient on the adjacent bed in the examination room, preventing them from falling.

“Are they still breathing?”

“Yes.”

About ten minutes passed…

“Hmm.”

The patient opened their eyes.

More accurately, they properly closed their eyes. For this patient, that means they’ve regained consciousness. They sat up.

“Are you feeling more alert?”

The hanyou patient perked up their ears, removing the damp eye patch covering their eyes. I was wondering when they’d wake up. Thankfully, it happened quickly.

“Where am I?”

“The clinic.”

“What about the arrow?”

The patient tried to get up, but Amy stopped them. With the chest tube still inserted, they’d need to carry the drainage container to walk.

“Hey, don’t move. You still have a chest tube inserted, and we’re draining fluid from your lungs.”

“What’s with the damp eye patch?”

“To prevent your eyes from drying out.”

“Ahh.”

I could clearly see the cat ears twitching through the patient’s hair – unmistakably a cat hanyou.

“I’ve removed the arrow from your side and sutured the resulting wound.”

“Understood.”

“However, we couldn’t treat the injury to the lung itself, so that will take some time to heal.”

The patient nodded.

“You’ve just passed the immediate crisis point. There are still many potential complications… You’ll probably need to stay in the hospital for at least a week.”

The cat hanyou patient’s ears twitched anxiously atop their head, seemingly on guard for approaching footsteps.

How did they end up getting shot by an arrow anyway?

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