Chapter 152: The Opening Shot

The new academic center faces its first test.

The patient's wife looked at the doctors' strange smiles in confusion. “Wait, what are you laughing at? Is there such a doctor or isn't there?”

Amused, Leo Cao said, “Comrade, the man standing in front of you is Dr. Xu. He cured every one of the patients you just mentioned.”^[1]

“What?” She stared. “But he's so young!”

Evan shook his head helplessly. The Abbess's father was quite a character. Were both of them such gifted publicists? She had just promoted Evan online and gotten the better of Dr. Cinnamon.

Her stubborn old father was even more entertaining. He was doing his publicity in person. Who would have guessed he had a talent for storytelling, telling his stories in the central park several times a day?

The daughter online, the father offline. What a pair.

“Young or not, let's see to the patient first,” Evan said.

“Oh, yes… yes.” Still stunned, she moved aside.

Evan stepped forward.

The young Chinese medicine doctors followed.

He examined the patient's face. The man looked exhausted and listless, with a little grime at the corner of his mouth. Beside him was a bucket to catch the blood he vomited.

Evan skipped the tongue inspection. The blood had obscured the tongue's appearance; it would need cleaning first, which would be troublesome.

He went straight to the pulse examination.

After a while, he asked, “You had the wine the day before yesterday?”

The patient lay propped up in bed, too uncomfortable to want to answer.

“Yes, the day before yesterday,” his wife said.

“Were you exposed to cold that day?”

“It rained that day, didn't it?” she complained. “He went out without an umbrella, got soaked, and caught a chill. He's been busy and exhausted every day lately, and on top of that he has to go to business dinners. He doesn't normally drink.

“He's had gastric ulcers for years. He's had gastric bleeding before, and they recently found hidden blood in his stool. He's always been afraid to drink. This time someone insisted.

“It was an important client. He couldn't get out of it. And since he'd been out in the rain, he thought a drink might help drive out the cold.

“One glass, and look what happened. Now that client who made him drink doesn't even dare come to see him.”

The patient lowered his head in embarrassment.

Evan nodded to show he understood. He stood and addressed the young doctors behind him.

“In Chinese medicine, gastric bleeding is often attributed to disharmony between the Liver and Stomach. Liver qi moves across to attack the Stomach, forcing Stomach qi upward so that the patient vomits blood. The treatment is to soothe the Liver and harmonize the Stomach.

“Or excessive Stomach heat may force the blood out of its normal course, leading to vomiting of blood. In that case, the treatment is to clear heat and cool the blood, stopping it from escaping its proper pathways.

“But every patient is different. You can't treat all gastric bleeding as blood heat. This patient's Stomach has long been damaged, and his middle qi is already weak. When middle qi is deficient, Stomach qi can easily rise against its normal direction.

“He doesn't usually drink, but the day before yesterday he drank because he'd caught a chill. Cold and heat clashed, causing blood to surge upward. You absolutely mustn't treat this as blood heat. We need to warm and restore the downward movement of Stomach qi. Which formula should we use?”^[2]

The young doctors thought it over.

The patient's wife watched Evan. Only now did he begin to seem like a specialist to her.

Alex considered it. “Baiye Tang?”

Several of the others turned to look at him.

Evan gave a small nod. “Correct. The Jinkui Yaolue says, ‘For vomiting of blood that will not stop, Baiye Tang is indicated.’ This arborvitae-leaf decoction combines cold and warm medicines, warming the middle while clearing heat and restoring downward movement. The baiye is light and clearing in nature; it clears heat and stops bleeding. Ginger and mugwort support it with their acrid warmth, warming and unblocking Stomach yang.^[3]

“Xiexin Tang, also in the Jinkui Yaolue, treats bleeding caused by heat forcing blood out of its normal course. It uses cold and cool medicines to stop the bleeding. Clinical treatment must follow the pattern. If you mistakenly used cold and cool medicines to stop this patient's bleeding, the blood would congeal and qi would become obstructed. You'd put him in danger.”^[4]

The author publishes the chapter on their official page, but these words were reproduced without permission.

They nodded.

Evan wrote out the prescription and issued it.

Once outside, everyone felt weighed down. This was the first patient their Chinese medicine academic center had taken on. If they failed at the very start, they would be a laughingstock. It would be hard to carry on their work after that.

And the patient's condition was serious. They were nervous.

Evan looked at their faces. “Why are you all so gloomy and worried? This center is here to take on critically ill patients. None of them will be easy to treat.

“This patient's condition isn't that severe. We'll be facing worse cases in the future. If even this frightens you, what will you do then?”

No one answered.

“That's not what they're worried about,” Leo said. “This is our first battle. If we fail the first time, it'll hurt morale. And there are plenty of people out there waiting to laugh at this center. You weren't involved in Director Du's preparations. You have no idea how much opposition there was, how many people mocked us for taking on more than we could handle!”

Evan paused, taken aback. He hadn't thought that far.

He frowned. “As doctors, we don't need to think so much about all that. We're here to treat illness and save lives. Let others think what they like. We just have to give everything we have to saving the patient.”

They nodded.

Once the prescription had been issued, the patient took the medicine. Evan went home, as did the other young doctors. Alex was on night duty, so he stayed to watch over him.

But they all knew that if the patient's condition still wasn't under control that night, their Chinese medicine academic center really would become a laughingstock.

Director Du had faced enormous pressure to get it established. There were far too many people waiting to see them fail.

Evan had reassured them. They were still worried.

Early the next morning, the first thing they did on waking was ask Alex about the patient in their group chat.

No reply. They called him. No answer.

The young doctors cursed him in the chat.

Still no reply.

Fine. Time to get out of bed and hurry to the hospital.

This was probably the earliest any of them had ever arrived for work. They weren't usually so eager.

As soon as they got there, they hurried to the inpatient ward.

Their first priority was to give Alex a beating, then check on the patient. Didn't he know how anxious they were? He had news and hadn't told them!

They couldn't find him, so they went to the patient's room instead.

When they reached the room, they found Evan and Alex already inside.

They stopped short. Dr. Xu was here so early. Had they really failed to control the bleeding? Had someone called him back first thing in the morning?

Uneasy, they crowded around the doorway and watched.

Evan was examining the patient's pulse.

Their hearts were in their throats. Had it worked or hadn't it?

“Alex,” one of them called softly from the door.

Alex turned, saw them, and hurried out. “Hey, why are you all here so early?”

“What do you think? What have you been doing? You had news and didn't tell us. We messaged you on WeChat. We called. You didn't answer!”

“I forgot my charging cable. My phone died, so I left it in the office.”

They were speechless. Then they hurried to ask, “How's the patient? Has he stopped vomiting blood?”

They watched Alex anxiously.

He gave a mysterious smile, looking thoroughly pleased with himself. “Take a guess.”

“Guess, my ass.”

“Get him.”

“Ow, shit!” Alex cried.

Reader Notes

Reader Notes

1. ↩︎ Comrade. Tongzhi can serve as a form of address, including in official or workplace settings. Leo uses it to address the patient's wife; it does not establish her political affiliation. The slightly formal wording is retained here. Source: Laishan District Government — Forms of Address, in “Etiquette and Customs” (in Chinese).
2. ↩︎ Different patterns behind the same bleeding. Evan is distinguishing traditional patterns within one biomedical complaint. “Middle qi” concerns the Spleen and Stomach's digestive functions; Stomach qi normally moves downward in this framework, while counterflow describes movement upward. “Blood heat” names a traditional pathological category, rather than a measurement of blood temperature. Warming and cooling describe treatment principles and medicinal properties, not simply whether a drink is hot or cold. The capitalized organ names identify traditional functional systems. These definitions explain Evan's reasoning; they do not independently establish his diagnosis or his account of the effects of rain and wine. Source: WHO — International Standard Terminologies on Traditional Chinese Medicine (2022).
3. ↩︎ Baiye Tang and the classic. Baiye Tang is the formula Evan selects. Baiye refers here to arborvitae leaf, also called cebaiye; tang denotes a decoction. The Jinkui Yaolue, rendered in this project as Essentials from the Golden Cabinet, is a classical Chinese medical text. Its sixteenth chapter contains the line Evan quotes and a formula listing baiye, dried ginger, and mugwort. The novel does not reproduce Evan's written prescription, so its exact doses cannot be supplied from this quotation. The classical text does not demonstrate effectiveness in this fictional case. Sources: Jinkui Yaolue Fanglun — Chapter 16 (Chinese primary-text transcription); Hong Kong Polytechnic University — Chinese Arborvitae Twig and Leaf (in Chinese).
4. ↩︎ Xiexin Tang. This is the contrasting formula Evan discusses, not the one he prescribes. The same classical chapter lists Xiexin Tang with dahuang, huanglian, and huangqin. Keeping its pinyin name distinguishes it from other formulas whose names also contain xiexin, such as Banxia Xiexin Tang. Evan's contrast concerns traditional medicinal properties and pattern selection. His warning about congealed blood and obstructed qi remains his clinical judgment in the story; the classical passage establishes the formula's textual presence, rather than proving that predicted outcome. Source: Jinkui Yaolue Fanglun — Chapter 16 (Chinese primary-text transcription).