Chapter 296 - 201: A Tough Battle

Chapter 296: Chapter 201: A Tough Battle

Jiang He came to the hospital today mainly for the patient in bed 42, Zhao Youcheng.

Some time ago, Zhao Youcheng had been diagnosed with Bismuth type IV hilar cholangiocarcinoma. The tumor had enveloped the right hepatic artery and portal vein.

At the time, the Attending Physician in charge of the bed, Lin Haibo, had already judged the case incurable and recommended discharging the patient.

It was Jiang He who had refuted this on the spot in the office, deciding on a plan to first perform a puncture to reduce jaundice, followed by an extreme resection via a posterior approach.

After the PTCD (percutaneous transhepatic cholangial drainage) was completed, observations showed significant results. As of today, he had met the criteria for surgery.

Jiang He found Lin Haibo and said, "Teacher Lin."

Lin Haibo looked at Jiang He, nodding with a smile. "Leader Jiang, you’re here."

In truth, Old Lin’s feelings were a little complicated right now.

’Who would’ve thought? In just over ten days, Jiang He had gone from a peashooter to a cannon and become a medical team leader!’

In terms of departmental hierarchy, Jiang He was now his equal, both being Attending Physicians leading a team.

Factoring in performance bonuses and the special hospital allowance, Jiang He’s current compensation was on par with an associate chief physician, perhaps even a cut above his own.

—This whole thing was so absurd it was off the charts. The epitome of ridiculousness.

Jiang He got straight to the point. "Teacher Lin, the patient in bed 42 has been transferred to my team. How’s his condition today?"

Lin Haibo found Zhao Youcheng’s lab report and handed it over.

"The drainage is working very well. We just rechecked his blood chemistry this morning. His total bilirubin has dropped from 385 on admission to 85. The drainage tube is producing about three hundred milliliters of bile per day, the color is clear, and the biliary pressure has come down."

"Has his albumin also improved?" Jiang He asked.

"Yes, we’ve been reinforcing his intravenous nutritional support with albumin and plasma transfusions. His current level is 35 g/L, which just barely meets the passing line. We also sent him for another 3D CT reconstruction this morning to calculate the remaining liver volume. There’s compensatory hyperplasia in the left lateral lobe and caudate lobe, and the FLR (Future Liver Remnant) assessment is within a safe range."

"And his coagulation function?"

"His PT (prothrombin time) is 13.5 seconds, also within the normal range."

Jiang He handed the lab report back to Lin Haibo and nodded. "With his bilirubin below 100 and his liver function in the compensatory window, now is the best time for surgery. We can’t delay any longer. If we do, and the tumor continues to invade, we’ll lose even this last chance."

"I know." Lin Haibo sighed. "But the difficulty of this surgery is undeniable. It’s a Bismuth type IV. Even with his markers in the acceptable range, once he’s on the operating table, it’s still a life-or-death gamble..."

Jiang He nodded in agreement. "Mm, I’ve already thought through the surgical plan and prepared three contingency plans for various emergencies. But for a major level-four operation of this magnitude, Teacher Yang still needs to be the primary surgeon. I’ll act as his first assistant."

Lin Haibo agreed completely. "Dean Zhang is quite strict. You’re in the spotlight right now, so it’s wise to play it safe."

The two exchanged a few more words about potential intraoperative problems before Lin Haibo left to tend to the patients on his own team.

Jiang He stood where he was, lost in thought for a moment.

’Although I’ve secured the position of medical team leader, my on-paper qualifications are still a limitation. I can’t perform many of the most advanced surgical procedures as the primary surgeon yet.’

’When will I be able to jump to the next level?’

’Perhaps I’ll have to wait until the trip to Hopkins.’

’Suddenly, this feels a bit like One Piece...’

’Every time Luffy gets stronger, he needs a teacher.’

’The fake teacher: Rayleigh.’

’The real teachers: Katakuri and Kaido.’

’So, how much gold will Wang Qian and Teacher Miller at Hopkins drop for me?’

’The main thing is, by the time I go to the US, the miRNA-based early screening for pancreatic cancer from our lab should be sorted out.’

’Standing in Hopkins’ centennial hall with a top-tier achievement like that, the international medical community will surely explode.’

’Returning home laden with honors, with recognition from the international medical world and a major commendation from the state—it wouldn’t be impossible to get an unconventional promotion to associate director then. It would be a natural progression.’

*Everything is going according to plan. I’ve got my own tempo.*

Snapping out of his thoughts, Jiang He walked over to bed 42.

The ward was somewhat quiet.

Zhao Youcheng lay on the hospital bed, so thin he was almost unrecognizable.

Beside the bed, Zhao Youcheng’s wife, an old woman whose face was etched with the hardships of life, was sitting on a small folding stool.

Seeing Jiang He walk in wearing his white coat, the old woman quickly put down the half-peeled orange in her hand and stood up.

"Doctor..."

"Ma’am, how is he feeling today? Is his appetite any better?"

"Much better, much better! He even had half a small bowl of congee this morning and didn’t throw up. Doctor, thank you all so, so much."

As she spoke, the old woman seemed to suddenly remember something.

She turned and pulled a red plastic bag from under the bedside table. Inside was a bundle of small Shatang mandarins.

"Doctor, this... these mandarins, we grew them ourselves. They’re not worth much, but they’re very sweet. Here, you take them. You must take them."

Homegrown fruit like this wasn’t considered a valuable item, so accepting it wouldn’t be a violation of the rules.

"Thank you, Ma’am."

He broke off a segment and put it in his mouth.

The pulp melted in his mouth, its juice light and sweet.

It was indeed better than the waxed ones sold at the market.

Jiang He praised, "They’re very sweet, Ma’am. You have a real talent for growing these. The harvest must have been good this year, right?"

Hearing Jiang He praise the sweet mandarins, the old woman’s face first lit up with a smile, which then quickly faded.

She glanced at her sleeping husband on the bed, and her eyes suddenly turned red.

"As long as they’re sweet, that’s good... The old man’s been growing them his whole life. These mandarins... they’re what he cares about most."

The old woman rambled on, wiping away her tears.

"Doctor, you don’t know, these mandarins... he guarded them with his life. Things were tough at the factories this year, so our son couldn’t send any money home from his job. This orchard was all our family had to rely on. The fruit merchants came to our door with big trucks and offered only thirty or forty cents a jin! That doesn’t even cover the cost of fertilizer for the next half-year. It’s not worth it! My old man has been thrifty his whole life, he couldn’t bear to sell them for so little. So he found some old bamboo baskets and carried them on a shoulder pole. One load is over a hundred jin, Doctor! His back is already hunched, and with the pole pressing down, he looked like he was about to bend right into the dirt..."

"There’s a van at the village entrance that goes to the county town, but they charge an extra five yuan to take the two baskets of fruit. He couldn’t part with that five yuan. So, in the pitch-black dark, he carried them over the mountain to the town himself... The dew is heavy in the mountains. Before he’d even walked two li, his shoes and pants were soaked through. When he got to the street, he’d see others eating a two-yuan bowl of noodle soup, but he wouldn’t even swallow his own spit, let alone buy a bowl. When he was hungry, he’d just take out a plain steamed bun from his pocket and eat..."

"He just works too hard... He’s unwilling to spend on anything. To earn that extra ten or twenty cents of profit, he’d have to bow and scrape and put on a smile when the city folk complained the peels were too thick or the fruit was too small. He said that if he sold one more basket and saved another eight or ten yuan, he could scrape together enough for Ah Bao’s room and board for the next semester. School tuition is free now, but once you get to the county middle school, food, lodging—what doesn’t cost money? A while ago, he was in so much pain at night he’d be rolling around on the bed. I told him to go to the town clinic for a painkiller shot, but he refused no matter what. He said one shot costs more than ten yuan, and it would mean his whole day’s work carrying mandarins was for nothing. He just gritted his teeth and endured it. When the pain got too bad, he’d bite his own lip until it bled..."

"Wooo... The money he earned, in tens and fives, he’d gather it all into a single stack and put it in the cabinet. He said that after he sold all of this year’s mandarins, the cabinet would be full..."

"But who knew... the money was never saved up, the mandarins were never all sold, the cabinet was emptied, and he... he turned yellow. Wooo..."

A load of over a hundred jin, a three-hour mountain path, a price difference of a few dozen cents.

It had broken Zhao Youcheng’s liver, and it had crushed this family.

Jiang He found it hard to listen to all this.

Even after so many years as a doctor, he still felt a deep sense of empathy.

Seeing Jiang He’s silence, the old woman quickly wiped her tears dry.

She seemed to feel she had lost her composure crying in front of this promising young doctor, so she turned again, grabbed more mandarins from the bag, and stuffed them into Jiang He’s pockets.

His white coat was soon bulging.

"Doctor, I’m not... I’m not asking you to guarantee you’ll save him... I know this illness is my old man’s fate. I just wanted to say, you all work so hard. If you eat a mandarin, soothe your throats, that’ll make me happy..."

After she finished speaking, the old woman grasped Jiang He’s hand.

Her hand was wet.

Wet with her own tears.

Jiang He squeezed the old woman’s hand and said gently, "Ma’am, don’t worry. We will do everything in our power."

The words were simple.

But in the depths of his heart, Jiang He had already given himself an ultimatum:

’I have to save Zhao Youcheng.’

’Sir, you haven’t sold all your mandarins yet. You need to be healthy for that.’

Just then, the door to the ward opened, and Yang Xu walked in.

"Jiang He, it’s about time."

Jiang He handed him a mandarin. "Teacher, try one."

Yang Xu took a bite. "Mm, not bad."

He took two more mandarins and put them in his pocket. Then Yang Xu said, "Let’s go. The people from anesthesiology, radiology, and critical care medicine have all arrived at the grand rounds room. We’re about to start the preoperative meeting. We’ll go over that posterior approach extreme resection plan one last time."

Jiang He nodded.

This was going to be a tough battle, one they had to win.