Manual Liver Gate Pinch

"Little Grete...?"

The young man stared blankly as he looked up at him. Wu Zhou ignored him completely, pouncing on the injured man's side and swiftly sweeping his gaze around—

No table.

No cart.

Not a single slightly elevated surface he could use as an operating table...

He had to treat a dead horse as if it were alive! Wu Zhou gritted his teeth. To a surgeon, everything below the waist was considered a contaminated area. Operating while kneeling on the ground was a complete violation of sterile protocol. But... in this godforsaken environment, there was no point worrying about sterility. Saving the injured man's life came first!

As he examined the situation, he barked out orders:

"You! Come here and press on his arm, right here! Press hard, don't let up. Yes! And here too, on his leg, where I'm pressing. Good, hold it tight! Harder! You! Press here! You! Take off his clothes!"

"I can't get them off..."

"Then tear them! Cut them off!"

The Deputy Director of Emergency Department's commanding presence erupted in full force, unstoppable as ever.

The three or four people around him were run ragged by his orders. Those assigned to compress wounds did so, those told to strip the injured man stripped him, and those told to boil water boiled water. Everyone was frantic. The person boiling water rushed in and out, darting back and forth between the little room and outside without even a moment to speak to his companions.

Even the Young Priest was shouted into using his left hand to compress the injured man's brachial artery and his right hand to compress the posterior tibial artery. Because the positions were so bizarre, he was kneeling and sprawled on the ground, twisted into a strange shape...

It was not as if no one doubted whether Wu Zhou knew what he was doing. But in the depths of despair, as long as one person confidently issued orders, the others would most likely obey on instinct:

It was like struggling in a flood. When you were about to go under, grabbing hold of anything at all—even a straw—was better than nothing!

Wu Zhou kept his eyes on the injured man while shouting orders. He bent his knees and knelt, placing his right hand on the man's neck. Steadying his own breathing, he counted the injured man's heartbeat, beat by beat:

The heartbeat was still all right. Under a hundred... Damn, it was getting faster and faster. There was probably massive bleeding! The carotid pulse was weakening, his face was pale, his skin was sweaty, his breathing shallow and rapid...

A string of information flashed through his mind, every piece of it troublesome. Blood pressure—he had no idea what it was. This miserable place did not even have a mercury sphygmomanometer!

He could only judge by sight!

Fortunately, Wu Zhou had worked in emergency medicine for many years and had responded to countless 120 calls. Whether an injured person was in critical condition and what injuries they might have, he could generally tell at a glance. Looking at this injured man now, the possibility of hemorrhagic shock was absolutely not low!

The injured man's leather armor had already scattered across the ground. His undershirt had been torn open, revealing a horrifying abdominal wound. A long gash, nearly twenty centimeters by visual estimate, slanted down from the upper right abdomen all the way to the lower left abdomen!

Blood surged out in waves. Wu Zhou took one look, and every hair on his body stood on end as his blood pressure shot through the roof.

Damn it! With this amount of bleeding, either an artery had ruptured, or the liver, spleen, or kidney had been torn!

He casually reached to his waist. A dagger gleaming with cold light appeared in his palm. Without a second thought, Wu Zhou fixed his gaze on the injured man's abdomen and raised the blade.

Thank heavens, this injured man actually had six-pack abs—the abdominal muscles were visible to the naked eye, which meant the anatomical structures beneath should be exactly the same as what he knew: beneath the skin was the rectus abdominis, wrapped in the rectus sheath. Cutting down through the rectus sheath would cause the least damage and avoid severing nerves and blood vessels...

In this world with Divine Arts, the injured man's—or rather, humanity's—anatomy had better be the same as before!

Wu Zhou focused, holding his breath as he cut along the wound in the injured man's abdomen, beside the right rectus abdominis. Time was urgent, and no one was there to hold retractors for him so he could carefully perform blunt dissection. This cut went straight through the anterior rectus sheath, the muscle layer, and the posterior sheath, all the way down. As the additional ten-centimeter incision was pulled open, dark red blood immediately gushed out.

"What are you doing?!"

The Young Priest kneeling opposite the injured man, whom Wu Zhou had ordered to apply pressure to stop the bleeding, screamed until his voice nearly broke.

Not only did he scream, the Young Priest lunged forward and spread his arms, instinctively blocking the space above the injured man's abdomen. His face was full of tragic resolve, every freckle on his little face declaring, "If you want to kill him, kill me first!"

Wu Zhou: "..."

Tsk, this was why family members could not be allowed into operating rooms. The moment they saw doctors cutting, clipping, and slicing their loved ones, would they not immediately charge in to fight for their lives?

Wu Zhou only had time for that complaint to flash through his mind. He tightened his grip on the dagger with his right hand, shoved the Young Priest's shoulder with his left, sending him reeling backward, and roared:

"Who told you to let go?! Go hold him down! If you don't keep pressing, he'll bleed to death!"

"But you—"

"I'm saving him! He's bleeding inside his abdomen too! I need to stop it! Move!!!"

"Oh..."

The Young Priest awkwardly shrank back into position, twisting himself into the same pose again and craning his neck to look toward the injured man's abdomen. Wu Zhou glanced over, saw that his compression point and posture were still reasonably correct, then returned his attention to the abdomen. He turned the dagger sideways and used its flat to push the abdominal muscle aside slightly, inspecting directly—

"What is that?"

The Young Priest across from him asked. Without looking up, Wu Zhou continued pushing aside the abdominal wall.

"The liver."

"Oh, it's the liver..."

The Young Priest muttered as he tried hard to see. Wu Zhou no longer felt like snapping at him. The sterile environment was ruined anyway; as long as this guy did not spit into the wound, he could do whatever he wanted. What mattered now was the injured man's liver!

Wu Zhou spotted the liver at once. Good, good. The organ positions had not changed, and neither had the anatomical structure. In this world with Divine Arts, humans had not become any stranger or grown some organ specifically for casting spells.

The left lobe of the liver, the right lobe...

"Ahhh, so much blood!"

"Shut up!"

Wu Zhou frowned. In the center of the bright red right lobe of the liver was a tear running downward through it. From the middle of that tear, bright red arterial blood was continuously pouring out!

His earlier judgment had been correct. There was indeed massive internal bleeding from an abdominal organ, and the bleeding organ was the liver!

A laceration of the liver parenchyma, depth... He did not dare turn it over to inspect. By visual estimate, it was no shallower than one centimeter, and with the heavy active bleeding—

This was definitely a Grade III injury! Not the most severe kind, but, but...

"Save him..." The Young Priest was already a complete mess, his trembling words fragmented beyond coherence. "Save... save him..."

Of course I'm saving him! The problem is, this kind of injury was nothing unusual in the emergency department. He could absolutely save him, but they were out in the wilderness with nothing available!

Wu Zhou's heart hammered so hard it seemed ready to smash through his ribs. He bent down, pulled apart the abdominal wall with his left hand, and reached deep into the injured man's abdominal cavity with his right. He lifted the liver, shifted the stomach, and moved aside the intestines...

"What... are you... doing?"

The Young Priest asked timidly. From the sound of his voice, he was nearly frightened unconscious—yet he was still watching. Since his courage was commendable, Wu Zhou did not begrudge him a few more explanations:

"I'm checking whether any other organs have massive bleeding. Mm, not the gallbladder, not the spleen either. The kidneys... the kidneys are farther back, so the chance of damage is low, but I still need to check... Mm, no obvious active bleeding there either. Excellent!"

"Then... then what?"

Then?

Then came the real challenge. In more than ten years of practice, Wu Zhou had only been forced to do this twice. In their entire provincial hospital, there were not even five doctors who dared to do it.

Amitabha, Three Pure Ones, God and Holy Mother, whichever god is listening... please let this injured man's anatomy not throw me any surprises!

He took a deep breath and carefully pinched the hepatic portal artery and vein.

"Wow! There's less blood! Less blood!... It stopped bleeding!"

The Young Priest cheered. The torrent of blood spraying from the injured man instantly slowed, changing from a rush to a trickle, then from a trickle to a seep. The hemostatic effect was visible to the naked eye.