Path of Medicine With a System

Not long after, Jia Suyue was brought back by Wang Yanan. Jia Suyue hadn’t run very far away. She had actually only stood at the office entrance. Zhang Fan had to greet her since she was Shao Hua’s best friend.

“Hello, are you feeling unwell?” Zhang Fan greeted Jia Suyue. Still, he turned to look at Wang Yanan to the side. Although Jia Suyue no longer insulted him, Zhang Fan still felt rather awkward around her whenever Shao Hua wasn’t also around. Jia Suyue had verbally attacked him far too strongly before, giving him too deep of an impression.

“It’s because of her per—” Wang Yanan was about to explain what was going on when Jia Suyue’s face reddened again, and she hurriedly covered Wang Yanan’s mouth.

“You can’t say it!” Jia Suyue really was getting slightly angry. Only an unmarried young woman like her would react like this. It was likely that a married young woman who already had a child would likely have explained what was going on three times over already by now.

“Alright, alright, I just happen to need to go out for a moment, haha!” Shao Hua’s feelings were more important to Zhang Fan than anything else. He would have to be nice to her best friend. Zhang Fan was no idiot. It was easy enough for him to guess why Jia Suyue was so embarrassed.

Jia Suyue had come to visit the hematology department together with Wang Yanan. It was almost certain that Jia Suyue was anemic. Moreover, Jia Suyue’s skin was rather pale, as were her lips. She typically liked to stay at home, which meant that she probably lacked exercise. Zhang Fan surmised that Jia Suyue probably also didn’t eat very much. So, Zhang Fan simply told Doctor Ruan about Jia Suyue really quick, and then left her office.

Zhang Fan actually had nothing to do, so he decided to pay a visit to Li Hui as he hadn’t seen the latter in quite long already. Ever since Li Hui got married, it seemed as if he had changed completely and become someone else. Li Hui no longer went out to bars. In fact, he had even completely stopped bothering Zhang Fan. It seemed like Li Hui had become the perfect husband.

Li Liang had also once mentioned the change in Li Hui before. Li Liang’s relationship with Li Hui became closer now that both were in Chasu City.

Li Hui’s wife was a teacher. She was three years older than Li Hui, and she had great emotional intelligence. There was a really pleasant atmosphere in her home. Although she was pregnant, she rarely got angry. She would even act spoiled to Li Hui. “Dear Husband, I’m tired, just look, my feet are swollen!”

Or, she would say, “Dear Husband, you’re the best! I’m so fortunate!” She successfully changed Li Hui into an adult! Apparently, Li Liang had learned such things when Li Hui got drunk with him one time. Zhang Fan almost spat with his laughter when he heard this. Li Hui had truly been conquered!

Li Hui had already been permanently assigned to the respiratory department, which was in the same building as the hematology department since both were internal medicine departments. Zhang Fan simply went down a few levels to go visit the respiratory department.

Meanwhile, after Wang Yanan saw that Zhang Fan had left, she said to Jia Suyue, “Why are you feeling so embarrassed? Just look at you. You’re actually acting shy!”

“Yanan!” Jia Suyue’s face reddened even further. She wouldn’t have been as embarrassed to see a male doctor that she didn’t know, but she was quite familiar with Zhang Fan. Of course she would be embarrassed to tell him about period problems.

“Fine, fine, I won’t say any more. Doctor Ruan is pretty skilled. I’ll take you to go see her, then.”

As Zhang Fan had guessed, Jia Suyue indeed had anemia. This was due to a combination of factors. She didn’t exercise very much. She didn’t eat very much due to wanting to maintain her thin figure. Additionally, her recent periods were heavier than usual. This all combined to make her feel dizzy and lacking energy.

This morning, Jia Suyue came to Chasu City Hospital and asked her friend Wang Yanan to take her to the gynecology department. The gynecology director gave Jia Suyue a checkup, and then directly told her, “You should go to the hematology department instead. Young lady, it’s no good for you not to properly eat your meals. You also need to exercise more. You’re still so young!”

There were many people waiting at the outpatient services section, and Wang Yanan didn’t want to cut lines, so she brought Jia Suyue to the hematology department. Coincidentally, Zhang Fan was here on rotation as well. Maybe Jia Suyue had matured, or maybe it was because she had become quite familiar with Zhang Fan, but she was far less prideful with him now than before.

Doctor Ruan checked Jia Suyue’s medical examination results, and then prescribed some iron supplements for her. She told Jia Suyue to take the iron supplements on a daily basis and come back later for another checkup. Wang Yanan and Jia Suyue then left the hematology department together.

“You need to exercise more. Otherwise, even taking medication won’t really help you!” Wang Yanan advised.

“Alright. Thank you, Yanan.” Jia Suyue intimately held on to Wang Yanan’s arm. Jia Suyue had long and wavy hair, while Wang Yanan had short hair. Both of them displayed different types of female charisma. Everyone passing them by, no matter if they were doctors or patients, couldn’t help but glance at them.

This was especially so for Wang Yanan. She was wearing a clean white doctor’s coat with her hands tucked into her pockets, along with soft flat-soled shoes. She seemed really strong and steady, which was an aura that had come from working for more than a year in the physically demanding job of being a surgeon.

“Alright, I won’t be seeing you off. I still need to go back and change my patients’ medicine. You need to remember to take your iron supplements on time every day!” Wang Yanan told Jia Suyue while bringing the latter to the exit of the internal medicine building.

“Yeah, you should go back since I’m sure you’re busy. I also need to go to my job now.” Jia Suyue wasn’t severely ill. The main problem was that she usually stayed at home without getting much exercise.

Her appetite wasn’t very large, since she wasn’t exercising much. Thus, she became slightly anemic due to having a bit of a heavy period. Jia Suyue’s anemia was the classical type of anemia caused by iron deficiency.

Anemia was an illness that would be caused by an insufficient number of red blood cells in the body. Iron was one of the main elements which would be used to create more red blood cells.

To give a simple explanation of red blood cell growth for adults, the red blood cells would be born in the bone marrow. The red blood cells would grow until they were shaped similar to the number eight, which represented that the red blood cell had matured. The red blood cell would then jump out of the bone marrow and start working in the blood vessels. Red blood cells were like truck drivers who would constantly work in the transportation industry. The red blood cell would become old after around 100 days. It would no longer be capable of working. Such a red blood cell would then pass through the spleen and be devoured by the spleen’s macrophage cells, ending the red blood cell’s life of work.

Red blood cells would be born in the marrow, work in the blood vessels, and buried in the spleen. The red blood cell’s components would then be reused in order to create new red blood cells. Normally, anyone who didn’t have major blood loss or long-term bleeding wouldn’t become anemic from iron deficiency.

However, the iron element was one of the most difficult elements for the human body to absorb through food. If iron became deficient, then it would be quite difficult to swiftly increase the amount of iron to resolve dizziness and discomfort from anemia!

Li Hui had just finished giving medical advice to a patient when Zhang Fan entered the respiratory department. Li Hui was really happy to see Zhang Fan. Although the two rarely met ever since Li Hui had got married, he was still quite happy to unexpectedly see Zhang Fan.

Zhang Fan felt that Li Hui appeared rather strange when he saw him. Li Hui had previously been the type who was always really poor, reaching the point where there were holes in his socks, yet even then, he would always ensure that his hairstyle was really clean and neat.

Yet today, Li Hui’s hair was actually really messy. There were also faint dark circles around his eyes. It seemed as if Li Hui had suddenly aged 10 years.

“What happened to you?” Zhang Fan asked in some confusion.

“Nothing! I’m perfectly fine!” Li Hui still held on to a medical report as he pulled Zhang Fan to the hallway. Li Hui hurriedly lit up a cigarette for himself. Zhang Fan took a glance and saw that the cigarette was the Red River brand, a really cheap brand that only cost three yuan.

“Are you lacking money?”

“Hey! My wife is several months pregnant, and my parents aren’t in the best condition, so I’m trying to save as much as I possibly can.”

“Feel free to tell me if you need money.”

“It’s fine. I can grit my teeth and handle it. I’m just a little sleepy!” Li Hui closed his eyes as he inhaled a deep breath of smoke.

“Is your wife not sleeping well at night?”

“That’s not it. I’m a bit fatigued because I’m managing too many patients.”

“How many patients are you managing? Is respiratory Director Jumabieke that cruel to you?”

“No, I personally requested all these patients. I’m managing more than 20 patients right now. I work overtime until 2 a.m. every single night. I have to work my hardest because I need money for everything. Sigh! I used to be so free!”

“You should rest a little!”

“It’s fine. I had too much fun before when I was younger. This probably counts as paying back what I owe! What about you? When are you getting married?”

“Probably soon!” Both men suddenly felt silent. The pressures of life felt like a rope that was tightening around them, not allowing them to easily breathe.

“It’s fine. What else can I do apart from work hard? Since I don’t have any money, I’ll just have to work even harder. Alright, let’s end this chat here since I still have to go back and finish my medical reports. The faster I can finish them, the earlier I’ll be able to return home. I’ll go out with you sometime after I have the free time,” Li Hui said to Zhang Fan while throwing away his cigarette stub.

“Alright. Make sure to pay attention to taking care of yourself.” Zhang Fan saw that Li Hui seemed to have a slightly hunched back now. Zhang Fan suddenly really missed the slick and energetic youngster Li Hui from before. Had Li Hui matured and grown up? Maybe this was the price of maturity.

Zhang Fan was slightly dejected as he returned to the hematology department. He felt as if he could see himself in Li Hui’s shadow. But, before Zhang Fan could really ponder this much, the hematology department received a certain patient.

This patient was a 68-year-old man. His three primary blood cells—the red blood cells, white blood cells, and blood platelets—had all started decreasing for no apparent reason. The patient suddenly started bleeding from his gums, his legs started swelling, and he started feeling dizzy. This all started two weeks ago. He received treatment from his local city hospital, but his condition didn’t improve, so he was transferred to Chasu City Hospital.

Today was Doctor Ruan’s turn to receive patients. When this elderly patient was hospitalized and Zhang Fan saw his medical information sheets, he could only feel extremely helpless inside.

Zhang Fan had been grinding by studying hematology for several nights before entering the hematology department. Although he was no expert in hematology, he already knew the basics by now. The diseases in hematology were even more troublesome than in rheumatology or endocrinology. Hematology diseases would almost always affect the entire body.

Hematology diseases were usually in the blood. However, the symptoms displayed in the organs would be impossible to accurately diagnose. There wouldn’t be much difference in medical equipment between a larger city hospital like Chasu City Hospital and a smaller city hospital. Both hospitals could only do their best to treat the elderly patient’s symptoms. This was all the hospitals could do because it was impossible to accurately diagnose the problem.

After this patient was hospitalized here, all sorts of examinations began on him. He kept pouting and complaining all the time. His old wife accompanied him and kept massaging his legs while trying to convince him to accept the treatment. Zhang Fan listened a little and learned that the old patient no longer wanted to be treated, but his children were refusing to let him stop treatment.

Later that afternoon, Director Li Qing finished performing outpatient services and returned to the hematology department. The patient’s examination results had come out by now. Since this patient was rather special, all of the hematology department members gathered together for a discussion, yet they were unable to conclude anything even after quite a while.

“This patient has idiopathic malignant cell histiocytosis with bone marrow metastasis!” Zhang Fan suddenly announced as he looked over the patient’s medical information.

“The symptoms do seem rather similar, but this illness is really rare. I’ve never met even a single patient with this illness before. Are you certain?” Director Li asked him.

“We should do a bone marrow biopsy and confirm!” Zhang Fan answered.

“Alright. Let’s do a bone marrow biopsy then so that we can confirm the diagnosis as quickly as possible.” Director Li nodded in agreement.

Actually, Zhang Fan was already quite certain that the patient had idiopathic malignant cell histiocytosis with bone marrow metastasis. He had read through countless hematology disease publications over the past few days, and had a clear memory regarding this disease because it had left such a deep impression on him.

Even though Zhang Fan was certain of his own diagnosis, there was still nothing that he could do. This disease was a highly difficult type of cancer that was impossible to treat by using any method. Surgery, chemotherapy, and radiotherapy were all ineffective against it. This disease had no cure.

“Please stop torturing me. I’m almost 70 years old already. Sigh!” The patient was filled with complaints when he had to get a bone marrow biopsy.

A few days later, the laboratory examination results came back positive. Zhang Fan’s diagnosis had been proven completely accurate. However, what could even be done for the patient’s sake?

The old patient had three sons, who all came to visit him in the hospital. The old patient had been a farmer for his whole life. He had successfully raised all three sons into capable adults. The oldest son was a small business owner who sold home electronics. The second son was a teacher. The third son worked at a nationally owned enterprise. The family’s overall financial condition was alright.

“Doctor, is there really no treating this disease? Will there be any hope if we try going to Beijing or Shanghai?” The oldest brother had always been the leader of the three brothers. He tried thinking of ideas for helping his father.

“Sigh. I’m sorry to tell you that he won’t be able to receive treatment for his condition no matter where he goes,” Director Li told the sons sympathetically.

The oldest son’s eyes became red and teary as he said, “Then, what can we do to slow down the disease? Our father’s worked hard for all his life. He hasn’t gotten to enjoy much of his life! Doctor, please help us think of something!”

“All that can be done is to constantly give him blood transfusions, hormones, and albumin injections. How much time he has left is really difficult to say. Not only that, the medical fees required for treatment will be quite high.”

“That’s fine, Doctor. It’s fine as long as our father can live a few extra days! What else should we pay attention to?”

“You should just let your father eat and drink whatever he wants. There’s nothing that he needs to pay attention to anymore. Also, if he’s in critical condition, should we attempt emergency treatment? If he requires emergency surgery, should we attempt it?”

“Let us discuss things with each other!” The three sons left rather dejectedly.

Some time later, they returned. “Treat him with whatever medication you can! Sigh!”

The medical fees were just like a slot machine that kept devouring a large amount of the patient’s family’s money. Albumin, blood plasma, imported antihemorrhagic agents, and so on were all medication that would be priced in the tens of thousands of yuan!

To treat or not to treat? In China, most of the time, the hospitals wouldn’t directly interfere with the patient’s family’s decision to continue medical treatment or not. There were many families who would continue useless medical treatment all the way until the patient died.

This was quite different from how medical systems worked in the west. To illustrate this with a story, there was once an old man who was a Canadian Chinese mega millionaire. He had a really late stage of cancer and was in really bad condition. At the Canadian hospital, the Canadian doctors refused to transfuse blood plasma or even inject any albumin for him.

The Canadian Chinese millionaire’s final wish in life was to return to China and visit his roots. The Canadian hospital sent three doctors and two nurses to help take care of him on the plane which took him home. The Canadians believed that caring for an old patient and seeing that his dying wish came true was really important. The Canadians also believed that useless treatment was nothing more than a waste.

The old patient at Chasu City Hospital remained hospitalized for one full week. This cost more than 70,000 yuan in medical fees. He was also getting weaker on a daily basis, which required more and more fluid infusion every day. The old patient’s ashen complexion was really noticeable in the afternoon with the sunlight’s illumination in the patient room.

The old patient’s wife went to the bathroom to dump the urine from his bedpan, while Zhang Fan gave the old patient a simple examination. The old patient had numerous plastic tubes stuck into his body. He was in pain, extreme pain!

After Zhang Fan finished his checkup, he was about to leave when the old patient suddenly grabbed his doctor’s coat with a shriveled hand. Zhang Fan looked at the old patient in surprise.

“Let me die! I’m begging you!”

Zhang Fan was really stunned by this as he stood by the patient’s bed. He understood. He understood why the old patient would make such a request. However, there really wasn’t anything that Zhang Fan could do! Euthanasia was illegal in China. Thus, Zhang Fan was completely helpless!

The old patient saw Zhang Fan’s expression of hesitation and helplessness, so he slowly let go of Zhang Fan’s doctor’s coat in disappointment. The old patient then slowly turned his head to look out the window. Zhang Fan exited the patient room awkwardly. Zhang Fan knew that he had no right to take action here!

Forcibly keeping someone alive until their death. Was that really filial piety? Was it really that bad to give up at such a time? Zhang Fan looked back at the old man who was in such pain. For once, Zhang Fan wondered if he was doing something wrong.