Chapter Twenty-Four: Poisonous Mushrooms

The stretcher was carried into the emergency room. When they reached her, Guo Fu asked, “What happened?”

Everyone in Sanya knew this second-in-command of the health center, the elite among the female nurses. A health worker who had accompanied them quickly said, “Food poisoning.”

“What did they eat?” Guo Fu asked as she walked, waving her hand. “Quick, put him on table number one!”

“They ate mushrooms,” a health worker said.

Poisonous mushroom poisoning. Guo Fu thought, this was the most common type of food poisoning here. No matter how many hygiene education classes were given to the laborers, no matter how many deaths had occurred before, the mushrooms in the mountains always held a strong temptation for the laborers, and someone would occasionally pick and eat them.

“Did you bring a sample?”

“Yes, here,” the health worker opened a laborer’s lunch box, which contained pieces of cooked mushrooms, a grayish pile. She pointed to a few laborers with pale faces behind her. “They ate some too, but their symptoms are not serious, just general weakness and stomach pain…”

“Stomach pain, diarrhea, vomiting?”

“Yes!” the health worker said in a panic. “They ate them last night. I don’t know when they picked them.” The female health worker’s face turned white with fear. “I really didn’t see them…”

She had seen cases of death from eating poisonous mushrooms and knew the serious consequences. The most crucial thing was that if such a major accident resulting in death occurred in the company she was in charge of, she would be sent back to Lin’gao to attend the “study class” organized by the Ministry of Health. The status of the “study class” in the minds of the naturalized citizens and natives was now second only to the “labor camp.”

“Don’t worry,” Guo Fu comforted her, while instructing the nurse on duty in the emergency room, “Quick, go and get Dr. He. All the nurses on duty who are free, come over!”

Guo Fu had the people with symptoms but not serious ones sit on the bench against the wall first, while she dealt with the seriously ill patient on the examination table.

The patient’s work clothes were soiled with vomit, and there were traces of watery stool on his pants, emitting a foul odor.

“Quick, help him take off his clothes!” Guo Fu said to the third-term nurse while wiping her hands with alcohol. The female health worker who had brought the patient, fearing that she would be implicated if something happened, quickly said, “I’ll do it.”

“Okay, the scissors are in drawer number five,” Guo Fu said as she opened the lunch box brought by the female health worker. She poured the mushroom pieces onto an enamel plate and poked at them with tweezers. The Ministry of Health had printed a lithographed book, “A Guide to Common Poisonous Plants and Animals on Hainan Island,” which not only had line drawings but also detailed descriptions of their morphology and color—because Lin’gao’s printing industry was temporarily unable to carry out large-scale color photo printing. This book was not only included in the training materials but was also a necessary reference book for all health institutions. Guo Fu had put a lot of effort into this book, but the shape and color of the mushrooms had changed after being cut and cooked. She could only tentatively identify them as some kind of boletus.

“How much did he eat?” Guo Fu asked.

“I heard them say there was originally a full lunch box,” the female health worker said. “The others didn’t eat much. This person was on the mid-shift. After his shift, he worked three more hours of overtime and missed the late-night snack. When he got back to the dormitory, he saw the cooked mushrooms and ate a lot of the leftovers, probably about half.”

“When did you find out?” Guo Fu asked.

“Just now,” the female health worker was terrified. “I went to the company dormitory to check on hygiene, and they carried him out, saying he had fainted. I really didn’t know they were secretly cooking and eating mushrooms in the dormitory!” She started to cry. “This will be the death of me!”

“Don’t cry!” Guo Fu quickly stopped her and asked, “How long has he been unconscious?”

“About an hour now.”

Guo Fu calculated and speculated in her mind. The mid-shift ended at midnight. This person had probably eaten the mushrooms around 3 a.m. The 7 a.m. whistle had just blown. According to the description in the medical book, the incubation period for boletus poisoning is 10 minutes to 2 hours. Since his symptoms only started to appear before 6 a.m., the incubation period was already 3 hours, which meant it wasn’t boletus… But the book also said that a few cases could have an incubation period of 6 hours. This made her a little unsure.

“Are there any fresh samples?” she asked, without much hope.

“No, I went to their dormitory to look after I found out about the poisoning…”

She lifted the patient’s eyelid and shone a mini flashlight into his eye. His eyeball moved nimbly, and he let out a groan.

“What’s his name?”

“Jiang Dashan.”

Guo Fu bent down over the patient and said directly into his ear, “Jiang Dashan, can you hear me? Jiang Dashan!”

His eyes moved slowly in her direction, and he nodded slightly.

“What’s your name?”

“Jiang… Da… shan…”

His level of response was enough to prove that his nervous system was not damaged—this should be gastroenteritis-type mushroom poisoning, the mildest type of mushroom poisoning. However, some mushroom poisonings, although they also manifest as gastroenteritis-type symptoms, are accompanied by organ damage. But the incubation period for this type is generally more than 10 hours, and the vomiting and diarrhea are not severe. She believed her judgment was correct.

She instructed the nurse on duty, Shi Jiemai:

“Prepare for intubation, saline solution, and a suction tube,” Guo Fu instructed, and then added, “The people against the wall, give them medicine to induce vomiting!”

The stomach emptying time is about 4-6 hours. Foods with higher protein content like mushrooms stay in the stomach for a longer time, so it was still not too late for a stomach wash. As for the other few people, it was a bit late to induce vomiting, but it might still have some effect. Anyway, their symptoms were not serious, and adding a laxative should be enough.

“I’ll go right away!” Shi Jiemai moved quickly to get the medicine and equipment. She was one of the best among the third-term students. The fact that she could take Dr. Shi’s surname showed that Dr. Shi favored her greatly. Not only was Shi Jiemai a diligent and quick learner, but her appearance, according to the “Comprehensive Evaluation Standard for Office Maids (1630 Edition),” would score 175 points, which was A-level.

“Give them magnesium sulfate after they’ve vomited!” Guo Fu called out from behind.

Magnesium sulfate heptahydrate is a chemical substance used in medicine as an anti-inflammatory, vasodilator, and laxative. The magnesium sulfate in Lin’gao was manufactured at the bittern factory of the Maniao Saltworks. Guo Fu gave them magnesium sulfate mainly as a laxative to help the patients empty their bowels as quickly as possible.

“Got it, and also fluid replacement to correct dehydration and electrolyte imbalance—” Shi Jiemai’s deliberately raised voice came from the other end of the corridor.

Guo Fu nodded helplessly. “Yes, and fluid replacement.” Although she was about the same age as Shi Jiemai, she had been through a lot and was more mature in her dealings with people.

After the equipment was ready, Guo Fu pried open the patient’s mouth, inserted a mouth opener, and skillfully inserted a tube into his throat, all the way down to his stomach. A nurse then handed Guo Fu a glass jar full of normal saline. Guo Fu poured part of the saline into the funnel at the top of the tube.

After pouring half of the solution, she waited a moment for it to flow into the stomach, then took the suction tube for the saline. She squeezed the suctioned liquid into a basin and then continued to wash the remnants of the mushrooms in this way. On the third suction, she found grayish, pasty food fragments. She washed the patient’s stomach cavity over and over again, gradually sucking out the food residue. She felt that the patient was out of danger.

“0.5ml of atropine subcutaneously, once every 6 hours! Intravenous injection of 5% GS solution and normal saline!”

Atropine was injected to relieve gastrointestinal symptoms such as abdominal pain and diarrhea. After injecting the atropine, Shi Jiemai quickly inserted an IV needle and administered an intravenous injection of normal saline and glucose solution to prevent dehydration and correct the electrolyte balance. At the same time, Guo Fu monitored the patient’s heart rate, pulse, and chest sounds.

Guo Fu felt that the patient had recovered a little strength and helped him sit up.

“100 grams of activated charcoal, mixed with water and taken orally.”

Jiang Dashan then drank a cup of activated charcoal. He didn’t want to drink this strange black water and coughed up some of it, but he was forced to drink it down. The activated charcoal water not only prevented toxins from entering the patient’s body but also neutralized some of the absorbed toxins.

Next, Guo Fu checked his blood pressure, pulse, and breathing again, and also checked his vision and reactions. She kept talking to him to confirm that all his nerve reflexes were normal, although his answers were weak and feeble.

Then she turned to deal with the patients with mild symptoms. These people, after being induced to vomit and given laxatives, were exhausted and lay limply on their beds, unable to speak. Shi Jiemai had already distributed oral glucose and saline solution to them according to the doctor’s orders to replenish their body fluids and restore their electrolyte balance. Shi Niaoren had requested at a Ministry of Health work meeting that everyone should avoid using intravenous therapy unless absolutely necessary. This was not only to save equipment but also to avoid the many dangers that could occur during infusion.

Seeing that everything was on the right track, Guo Fu sat down and began to write the medical record. The female health worker nervously shuffled to the side of the table.

“Is he okay now?”

“He should be fine,” Guo Fu said, continuing to write the medical record with a dip pen. “I’m going to write a report on this matter…”

The female health worker’s tone was almost pleading. “Please have mercy on me and put in a good word for me with Dr. He… I don’t want to be sent back to Lin’gao to attend the study class.”

“No deaths means it’s not a major accident with serious responsibility,” Guo Fu comforted her. “Besides, they secretly picked and ate the mushrooms themselves, so they are also responsible. Your responsibility is not great.”

“Thank you, thank you…” The female health worker almost knelt down and kowtowed, but of course, this was not allowed in the Lin’gao system. The female health worker’s fear was not without reason. The salary of a health worker was much higher than that of a general laborer. Once they were sent to the study class, they would lose their freedom for several months, and their salary would be reduced to a small living allowance. For many employee families, this was a rather terrible blow.