Path of Medicine With a System

Spring would always be the most pleasant season in Chasu City. The lazy sunshine shone through pear blossoms outside the window of Wang Yan’s patient room and illuminated her body.

The white pear blossoms seemed to glow with endless spring. A gentle and lazy light went all over Wang Yan’s black hair and gently caressed her face. The red rash on her face seemed almost demonic!

Even though spring sunshine was supposed to help everything come back to life, this light didn’t bring any signs of life to Wang Yan at all. This gentle sunlight on her face only made her red rash even more noticeable.

The rheumatology department director arrived. The vice director and the two other attending physicians in the department also arrived. When rheumatology Director Wu Wanghong saw Zhang Fan’s expression which indicated that the latter was having difficulty telling the patient’s parents about the patient’s medical condition, Director Wu directly accepted the responsibility of informing the parents. “Doctor Zhang, you and Vice Director Li and the others should go check on the patient. I’ll discuss things with the patient’s family.”

“Okay, Director!” Zhang Fan led the other doctors to Wang Yan’s patient room. Although Wang Yan’s life had been saved and the major internal bleeding had been stopped, she was still currently in a really bad condition.

As Zhang Fan performed a checkup on her and also checked her medical information, Wang Yan simply lay there like an expressionless zombie, blankly staring at the beautiful white pear blossoms outside the window.

“The current medication isn’t having any effect at all. Maybe we should try a large amount of hormonal therapy,” rheumatology Vice Director Li commented to Zhang Fan as he furrowed his eyebrows outside the patient room after the simple checkup for Wang Yan was finished.

“But in this situation, won’t too many hormones cause her to bleed again?” Zhang Fan asked because he was uncertain. There were far too many things to consider and balance in internal medicine.

This was even more so for patients who were in severe condition. Using medicine on them was far too difficult. Medicine might cause a reaction in the body which would then lead to the patient’s death. Not using medicine would also mean that things were only a matter of time.

Things were so difficult for doctors. It wouldn’t be a legal problem for the doctors if the patient died from major internal bleeding or natural causes. However, if the patient instead died because of a reaction to medicine that was used, that could cause all sorts of legal problems for the doctors.

Should the doctors use medicine or not? They would have to be extra careful!

“Let’s have an internal meeting to discuss the patient’s condition. We must hurry. Let’s finalize a decision within half an hour,” announced Director Wu as Vice Director Li was frowning while looking at the patient’s medical information. Director Wu had finished talking to the patient’s parents already.

Every single doctor of the rheumatology department arrived in the department’s small conference room. The director, vice director, attending physicians, resident doctors, and rotation doctors were all present.

Zhang Fan checked the time with the clock on the wall. It was necessary to record the time and everyone’s opinions in the final medical report. For these types of major meetings involving the entire department, the doctor who was in charge of the patient would also be in charge of recording everything that was said.

After everyone sat down, Director Wu nodded towards Zhang Fan, and declared, “Let’s begin the meeting. First, Doctor Zhang should give us a brief introduction.”

“Patient #9 was hospitalized on the 3rd of the month due to systemic lupus erythematosus which caused a high fever in her. She’d already tried to take some medication before hospitalization, which was quite ineffective. When she was hospitalized, I asked about her medical history and learned that she had previously sunbathed directly under the sun approximately six months ago. After she was hospitalized, I gave her the standardized treatment for her lupus symptoms. However, the treatment was ineffective. On the afternoon of the 5th, the patient started having large patches of purpura appear on her body. According to the standard blood test, her blood platelets were rapidly decreasing in number. Today, after the patient’s family members went to talk to her, the patient became extremely emotional, which caused a gastric vein under her stomach to rupture, leading to major internal bleeding. Attending physician Hu Jun and myself participated in providing emergency treatment to the patient. Currently, the patient’s medical condition is stable, but there’s still high risk of major internal bleeding or even death,” Zhang Fan summarized the patient’s condition. He then sat down after glancing at the director.

“Alright. That’s basically how things are. Time is of the essence here. Everyone should understand. Let us all directly state our opinion. Doctor Chen, you go first.”

Chen Hong was a rotation doctor. She was the same age as Zhang Fan. For major meetings involving the entire department, usually the doctors would speak in the order from lowest to highest rank. The department director would then make the final decision.

“The patient’s condition is currently stable. Although there’s still risk of major internal bleeding, I think that we can continue observation. That’s all for my opinion!” Chen Hong wasn’t interested in being permanently assigned to the rheumatology department, so she didn’t put much effort into her opinion.

The doctors each gave their own opinion. There were basically two different opinions here. The first was to continue observation, while the second was to obtain the patient’s family’s consent and take a risk with medication. The difference in opinions reached the level of an argumentative debate when it reached the veteran doctors such as those with the second-highest level certification and the vice director.

This wasn’t a power struggle, yet was even fiercer than one. This was a battle between two different ways of thinking, or perhaps it could be described as a battle between ideologies.

Modern medicine was making rapid advancements. However, there were still countless incurable diseases out there.

As the saying went, when a person’s life was nearing its end, some people would try their best to persist, while others would choose to give up instead; sometimes, some decisions would be unavoidable.

None of these decisions would be right or wrong when it came to death. Nobody would have a guarantee when death was approaching. Doctors weren’t gods. Nobody would be able to predict what might happen next.

For a disease like lupus, although using a small amount of medicine on the patient was already proven ineffective, using more medicine might directly cause major bleeding and kill the patient. All of the highest-ranking doctors under the director had now finished speaking their opinions. Everyone thus turned to look at rheumatology Director Wu.

Director Wu rarely smoked, yet today, he asked for a cigarette from the vice director, lit the cigarette, and inhaled deeply. He contemplated the issue quite seriously while being surrounded by smoke.

This was a truly difficult decision! It was incredibly difficult. Wait for death? Save the patient’s life? Kill the patient? Countless possibilities kept floating around in his mind.

He then asked for one more opinion! “Doctor Zhang, what do you think?” Director Wu had noticed that Zhang Fan hadn’t spoken his own opinion, as Zhang Fan had been busy recording everyone else’s opinions.

“We should treat her with medicine. She’s so young. She’s not even 30 years old yet! Although it will be quite risky, I think that we should attempt to fight her disease!” Zhang Fan stated while also recording down his own opinion.

Director Wu didn’t say anything in response to this. He took another deep breath of smoke, then suddenly put out the cigarette, and stood up while announcing, “Vice Director Li, you and Doctor Zhang should swiftly inform the patient’s family of the patient’s condition one more time and try your best to obtain their signature of consent as quickly as possible. Doctor Hu, prepare the medical equipment for treatment. Doctor Chen, report to the higher-ups of the hospital! We’re going to use medicine, a large amount of hormones!”

“Yes!” All the doctors got up and prepared to carry out the director’s orders. Having a director was really important for situations like this. Normally, the director’s importance couldn’t be seen, but it would be their decision to make in critical moments such as this.

Such a decision was basically one with no redos. The patient would either live or die. There was no third option. It was likely that the pressure and risks involved with this would still follow a director even after their retirement.

Right now, the director didn’t have the time to be sad or empathetic, because the patient was still in a poor condition while waiting for his decision.

The doctors finished all of the necessary preparations for treating Wang Yan, only to discover that they were now stalled by the final necessary requirement. They still required her husband’s signature of approval! Finally, the hospital was able to get in contact with the husband, who said that he would come to the hospital in half an hour!

The hospital didn’t dare to treat Wang Yan without her husband’s signature of approval due to Chinese laws. Wang Yan would have had a much easier time receiving treatment if she was a widow!

The doctors all waited as time kept passing! Were they impatient? Not at all. Sometimes, the doctors could really do nothing but wait in hope when faced with a patient’s potential death. Maybe the passing of time would help to cure the patient!