Chapter 314: Medical Planning
Now Hippo and Shi Niaoren tied off and severed the arterial vessels to minimize bleeding during the dissection. Shi Niaoren retrieved the aspirator tube from the instrument rack above the table, stepped on the pneumatic valve, and suctioned out the blood pooling in the abdominal and thoracic cavities.
When Hippo began to peel back the scalp in preparation for the craniotomy, someone finally couldn't contain herself and rushed out to vomit.
"Shall we take a break?" Ai Beibei asked.
"Might be wise. We'll be using the saw to open the skull shortly." Shi Niaoren held his hands beneath the faucet, rinsing the bloodstains away.
After a ten-minute intermission, the dissection resumed. Ai Beibei asked whether anyone wished to leave. No one withdrew. They were teachable after all. Only by passing this ordeal could they hope to become physicians.
Yet when the saw bit into the skull, one student did step out, returning only after a considerable interval. The grating rasp of surgical saw against cranial bone was chilling; only Hippo, who had worked in orthopedics, found the sound unremarkable.
Shi Niaoren pried open the skull cap with deliberate care, revealing the meninges enveloping the brain. This level of exposure was sufficient to make weak-nerved first-year medical students faint. He surveyed the nurses once more. They seemed to be holding on. In some eyes, he noticed a spark of something almost like enthralled fascination.
"Attention. I'm cutting."
Shi Niaoren warned them, then used sharp scissors to sever the large vein running from front to back along the center of the meninges. He realized suddenly that he had forgotten the name of this vessel—Am I getting old? Blood welled up immediately, flowing over scissors and fingers. He noted the blood was fluid, showing no coagulation. This man had clearly not died of cerebral infarction. After carefully examining the meninges, he peeled them back, exposing the brain. With delicate scalpel work he separated brain from spinal cord and gently extracted the organ. Ai Beibei brought a glass jar half-filled with formalin. Shi Niaoren lowered the brain slowly into the solution. The specimen was in excellent condition; he decided to keep it.
"This is the human brain. If the entire human body is a country, the brain is the Imperial Court." He explained in accessible terms, then covered the distinctions and functions of cerebrum, cerebellum, and brainstem. After that, his scalpel turned to the heart.
Shi Niaoren removed the heart from the corpse and examined it carefully. He addressed the female nurses.
"The likeliest cause of sudden death is coronary heart disease. Let us first determine whether this hypothesis fits."
The nurses, now somewhat numbed to the gore, focused their attention on the organs themselves, watching intently as he deftly opened the coronary arteries.
"We should find an embolism point here..." He indicated with a metal probe. "But there is nothing. In the main branch of the coronary artery, we observe no traces whatsoever of blood clots."
"Now let us examine the heart itself." Shi Niaoren placed the organ on the dissection board and bisected it. He examined the valves, then beckoned the nurses closer. They approached hesitantly.
"He did not die of coronary heart disease," Shi Niaoren concluded. "In this heart, we observe neither acute thrombosis nor myocardial infarction complicated by ventricular aneurysm."
"Then what killed him?" He indicated the heart with his probe. "The left ventricle shows significant dilation, and there is formation of grayish-white myocardial scarring. He suffered from rheumatic heart disease. This is what induced his sudden death."
He set down the probe. "Take a close look."
He did not expect these girls to become real physicians in a year or two, but at minimum they needed to overcome all terror and superstition about the human body.
Guo Fu had steadied herself by now. She felt she could endure this. Shortly after the dissection began, when she'd watched the saw cutting into the skull, she had felt the blood drain from her head and grown dizzy—she had nearly fainted. But she had resolved to persist.
For reasons she couldn't fully articulate, she recalled an incident from her wandering days. Tian Liang had suffered a festering calf wound and developed a fever by the time they reached a small town. A wandering traditional doctor, taking pity on them, had treated him—cutting away all the rotting flesh until fresh red tissue appeared, then applying medicine. No one else dared to watch; only she had remained at Tian Liang's side to assist. Afterward, he limped for months before fully recovering. She had tended him throughout, never fearing the blood and pus, never recoiling from that terrible gash. The memory gave her strength now. Once she passed this test, autopsies in the future would present no difficulty. Someday she would heal people, just as the Chiefs did.
After demonstrating the lungs, the dissection teaching session concluded. Hippo returned the removed organs to the body—there was insufficient preservative to store them as specimens.
Shi Niaoren asked, "Who is willing to suture the incision?"
The girls exchanged uncertain glances. This was demanding work.
"I will." Guo Fu stood.
"Good. Go change. Let me see your suturing skills."
Health School students had all learned wound suturing, though practice opportunities were scarce. Fortunately, suturing a corpse didn't require excessive care or concern about scarring. Guo Fu worked with evident meticulousness, though her technique remained imperfect.
"Passable." Shi Niaoren nodded. Hippo nodded as well. Ai Beibei allowed herself a faint smile. Technique was average; attitude was excellent. This girl had a future worth cultivating.
The corpse was rinsed, lifted onto a cart, and covered with white cloth. Shortly it would be transported to Cuigang for burial. Though the basement was cooler than above, with so many bodies crowded together it still exceeded twenty degrees. Decay would set in quickly. In a proper medical school, others would handle this—here, they did everything themselves.
They changed, emerged from the dissection room, and returned to ground level. Hippo exhaled stale air and wiped the sweat from his brow.
"We need air conditioning."
"If you ask me, cold storage would be better." Shi Niaoren lit another cigarette. "The current temperature is untenable. When summer comes it'll be deadly—the room will feel like a steamer. We won't even be able to store medicine."
"Didn't Li XiaolĂĽ draw blueprints for geothermal air conditioning? I think we can apply for that. Summer is coming anyway." As Hippo spoke, the nurses filed out. Guo Fu approached.
Hippo felt an ambiguous sensation as this young woman drew near—the figure outlined by her starched blue uniform, the fluffy hair beneath her cap. He steadied himself.
"Good work today, Little Guo," he praised.
"Thank you, Doctor." She blushed faintly. A delicate scent rose from her neck. Is this the body fragrance of a virgin? Hippo's thoughts wandered. Guo Fu was quite attractive by 21st-century standards. After months of adequate food and exercise, her figure had filled out. Her chest wasn't small, and though the uniform wasn't a dress, it was form-fitting.
"Little Guo! Come here!" Ai Beibei called.
"If there's nothing else, I'll go. Goodbye, Doctor." She gave a slight bow with a smile and turned away. I want this girl. The thought crystallized in Hippo's mind.
Guo Fu caught up with the others. They were asking what she had been thinking while suturing, whether she'd been frightened. She answered absently, her thoughts on Doctor He's peculiar gaze. Her face reddened again.
After Ai Beibei dismissed the students, she proceeded to the Chiefs' Conference Room as usual for the weekly Monday hospital meeting. The so-called Conference Room was a comfortably appointed large chamber with enormous glass panes in the windows, furnished with several old sofas where they could sit and converse at ease, reading newspapers or books. When they had spare time, they liked to gather here; the atmosphere felt more like home.
He Ping was participating in the circumnavigation of the island and hadn't yet returned from sea. His wife, Zhao Yanmei, attended in his place. She had been a mold laboratory technician at a pharmaceutical factory, and her participation in the transmigration was purely the result of deception—He Ping had lied that a boss wanted to open a pharmaceutical company.
Now Shi Niaoren was indeed preparing to put her in charge of the pharmaceutical factory.
"Meeting begins. Little Zhao, you'll take the minutes." Dean Shi called out. "Is Ziyi here? Go fetch your husband. Yes, though he's a veterinarian, he's also a doctor."
Shortly, Yang Baogui arrived as well, his arms still damp, smelling of disinfectant throughout.
"Another meeting. I was just breeding cows for the farm."
Last to enter was Liu San, a Master of Traditional Chinese Medicine. He now served as Chief of the TCM Department, though he rarely appeared at the hospital, spending most of his time on medicinal plant cultivation at Wu Nanhai's farm.
"All right, let's review last week's progress." Shi Niaoren opened his notebook. "First, our operating room and dissection room are now complete..."
After considerable effort, Bairen General Hospital had established a functional operating room. Equipment and instruments were straightforward—much had been brought ready-made, and the Feng City's infirmary contained a simple operating room that served as backup and a source of spare parts. The difficulty lay in acquiring basic support items. Things like ceramic tiles and ceramic disinfection basins had only recently arrived from Fujian kilns. Additionally, two surgical assistants had been trained from among the nurses; they could now manage suturing of major vessels and wounds, though barely. The real problem was the lack of a professional anesthesiologist. Every simple surgery left those poor patients howling like ghosts.
"...Our boiler room is complete. Boiler workers are being trained by the Energy Ministry. Fuel and soft-water quotas have been approved. We anticipate firing it up and putting it into operation soon."
A boiler room was a tremendous convenience. First, sterilization could employ high-temperature steam rather than the crude moist-heat method. Large volumes of washing and disinfection work could be performed in-house. Staff and inpatients could bathe at the hospital. As the weather grew hotter, this was essential for maintaining hygiene.
"...The agar needed for the microbiology culture room in the testing center has been the subject of a joint agreement with the Navy and the Ministry of Agriculture's biological laboratories. The Navy will supply raw materials; the pharmaceutical factory will produce the agar centrally. Equipment arrived from the glass factory last week. Somewhat rough, but better than nothing."
The microbiology culture room was crucial. They could finally test for bacterial infections and identify infectious pathogens. In the preceding phase, Shi Niaoren had used water sedimentation and concentration methods to check random samples for parasite eggs. Over recent days, a dozen positive specimens had appeared each day. He was considering whether to conduct a general survey before long.
"Judging from current data, the infection rate for parasites has risen significantly. This indicates that the tendency to eat indiscriminately in the wild is on the rise again. We need to notify the Propaganda Department to strengthen public education on this matter." Shi Niaoren summarized his points. "Next, Director Ai will address medical education."
Ai Beibei adjusted her glasses. Having spent many years in the United States, her Mandarin carried a faint accent.
"The health training class we assumed from the Military and Political School system is currently focused on nursing instruction. This is far from adequate. At minimum, we need to train medics capable of basic diagnosis and treatment.
"Currently, our largest-scale training in this area involves cooperation with the Army, Navy, and Resource Ministry. The first cohort of medic training—for both transmigrators and indigenous personnel they've sent—has concluded. The overall response has been positive. Once institutionalized, this will guarantee the most fundamental military health requirements in wartime.
"I believe this should be our direction in the near term. This type of education is crash-course training: operation-focused, with simple theoretical knowledge. We can borrow from first-aid courses run by organizations like the Red Cross—training first responders in three-month cycles, specifically emphasizing emergency care and basic treatment. We can also reference the barefoot doctor training system used in rural areas during the 1960s and 70s."
Though the barefoot doctor system had been eliminated after Reform and Opening Up, it was undeniable that it had covered the fundamental rural medical network at lower cost. This held reference value for the Transmigration Group, which faced similar constraints. Shi Niaoren agreed deeply.
"As for nursing training, the first nursing class has graduated and been capped. However, by strict standards, their professional level can only be described as 'unqualified.'"
Zhang Ziyi nodded. This was beyond dispute.
"They can only realistically be counted as orderlies by modern metrics. They've had too few internship opportunities, and various consumables and medicines remain insufficient." Zhang Ziyi continued, "No specimens, minimal equipment. Apart from alcohol and cotton wool, the supplies nurses can actually use are almost zero. We don't even have Mercurochrome."
To emphasize the point, Zhang Ziyi counted on her fingers: "As of now, the only items nurses can freely use are: medical alcohol and saline for washing wounds. We cannot even prepare physiological saline for intravenous use."
(End of Chapter)