Chapter 2229 - Doctor Xie Discusses Medicine

To be fair, with a skilled transfusion technician and proper anastomosis equipment, even transfusion surgery would not be particularly difficult. The problem was that Song Junxing was not a specialist in this. When it came to maxillofacial trauma, he could call himself—without false modesty—the foremost authority in this era. But suturing blood vessels? He was not necessarily any better than a senior naturalized physician like Xie Yao.

"We have very low requirements for transfusion surgery and use the simplest emergency technique, so even the least experienced physician can perform it on the front line..."

Song Junxing recalled Lin Motian's confident public assurance, and his lips twitched. He grabbed the instrument pack and headed for the emergency OR.

Nothing to fear. Sew first, ask questions later. Song Junxing steeled himself. After all, everyone had been thrown in at the deep end for years now.

Preparations for the exploratory laparotomy were nearly complete. Dark-green drapes covered the patient, leaving only one arm jutting out for transfusion.

Sterile conditions in this era could not compare to the old timeline—least of all in a front-line medical station in a semi-pacified zone. Having a drape at all was luxury. Song Junxing said nothing; he began disinfecting and draping the arm.

Once the patient was wheeled into the OR, Chen Ruihe's work was done for now. With both senior doctors in surgery, he—the first-line physician—had to stay up front handling the clinic.

By now, the ER had calmed somewhat. Casualty intake was basically finished. Anyone who had not made it back to the county seat by nightfall would likely not see the next sunrise. Occasionally, a lightly wounded man or someone with a comrade's help would spot the beacon fires and stumble back; the rest vanished into the forests along the road. A few bodies would be found at dawn; others became two words on a certificate: "Missing."

Chen Ruihe stretched, glanced into the observation room. Wang Chuyi had been taken to orthopedics for amputation. Thinking of the tourniquet that had never been loosened, Chen Ruihe sighed and shook his head.

Xie Yao finished the exploratory laparotomy past midnight: the spleen could not be saved; it was removed. Red-eyed, Xie Yao told the nurse to call him if anything came up, then pushed through the door to the duty room and fell asleep.

The night shift was relatively quiet. Xie Yao and Chen Ruihe each managed three or four hours' sleep—Chen Ruihe was quite satisfied with that.

"Now that you're working independently, how does it feel?" After handoff, the two sat in the county cafeteria, relaxed. Xie Yao ate and asked.

"Not bad..." Chen Ruihe said slowly. "Just a bit... chaotic, I guess..."

"Scared?"

"A little, at first." Chen Ruihe was slightly embarrassed. "I've seen work injuries in Guangzhou, but these front-line soldiers—covered in blood, legs smashed to pulp, maggots in their flesh—way more frightening than Guangzhou. I'd say... maybe it's disrespectful, but it felt like the Ming world."

"You've hit the nail on the head. These ER patients are pitiful beyond words: the ER is the part of Council territory most like Ming." Xie Yao spoke with feeling. "Every time I'm on ER duty, I think of the old days: nothing but crying and screaming; the stench of feces and rot everywhere; people dying and already dead all over the floor. Your heart aches, but you can only watch—whatever you do is a drop in the bucket. You can't save their lives; you just watch them die. And they don't even die with dignity. Officials and nobles, beggars in rags—when disaster strikes, they all look the same."

"A drop in the bucket...?" Chen Ruihe felt his worldview crumbling. "But... the Council's medicine is the divine art of raising the dead and regrowing bone—how can it be 'a drop in the bucket'?"

"We physicians can cure disease, but not fate. Though the Elders possess great knowledge and power, they are still flesh and blood—not immortals. Where in this world is there an art that can truly raise the dead? However skillful the medicine, there are still incurable illnesses."

"But... even if we can't cure fate, the Council can! Elder Lin says, 'The people are poor and therefore filthy; filth leads to disease.' Isn't that because the Ming world was bad? Now that the Council has liberated Liangguang and life is better..."

Xie Yao gave a cold laugh. "By your logic, those who live in comfort should fare better than corpses by the roadside—on the road to the underworld, each should stroll leisurely to reincarnation?"

Chen Ruihe did not answer, but his expression showed he agreed.

"The underworld is the most impartial place there is—no favoritism like the world of the living. When a patient's three souls and seven spirits leave the body and the ghost-judge comes with his warrant, it doesn't matter whether you were rich or poor—nothing helps. What difference is there?" Xie Yao picked his teeth as he spoke.

"Early on, I was assigned to the army. All I saw were Fubo Army soldiers and quarantine-camp refugees—mostly hard-luck cases, similar backgrounds, nothing to compare. It was only in Guangzhou that I finally saw what wealthy patients looked like." Xie Yao reminisced slowly. "My first wealthy patient was an old matriarch from a gentry family. Supposedly pampered in silk and jade, she had the misfortune of suffering from xiaoke syndrome..."

"I know that—it's the traditional medicine term. It's just diabetes, right? Elders say it's a metabolic disease, the hardest to treat."

"Yes. If she had been brought to us a few years earlier, she might not have deteriorated so badly. A cure was impossible, but she could have lived longer and more comfortably. But traditional doctors didn't understand the pathology of metabolic disease—they couldn't treat it systematically. Every doctor had a different theory. Over more than a decade, she drank enough herbal decoctions to fill several vats—none of it helped.

"By the time she reached Provincial-Hong Kong General Hospital, her diabetic foot was so bad you couldn't touch it. Both feet were rotting; bone was poking through the flesh. The day they brought her to me, she had only a thin breath left.

"At that stage, there was no saving her. The foot ulcers were classic diabetic ketoacidosis. No one wanted to keep such a patient. Internal medicine stabilized the acidosis and half-saved her life, then dumped her on orthopedics to deal with the rotting feet. Orthopedics didn't want her either—even amputation couldn't control the infection. On some pretext—'infection not controlled, possible concurrent stroke'—they dumped her on me. As the saying goes, 'Long illness, no filial sons.' Her several sons, though all prosperous and willing to spend money, would not attend at her bedside. Learning that the Song hospital could keep patients for 'admission,' they cared nothing for appearances and admitted her at once—clearly they wanted to be rid of the old matriarch. Fortunately, they did spend freely, so she stayed on in the ward.

"The old lady was confused when she arrived—no wonder orthopedics suspected stroke. But what could I do with such a critical case? After a day of fussing, I sent her to orthopedics for amputation, then got her back. The old matriarch was dazed; when the anesthesia wore off and she saw both feet gone, she burst into tears and could not be consoled. She cried until exhausted, then fell into a stupor; woke, and cried again. She had been pampered all her life; now, with her mind unclear, who could comfort her?

"That was bad enough, but the old lady was fated to suffer. You've taken surgical courses—you know what happens after prolonged bed rest. Within days, bedsores sprouted everywhere. With diabetes, infection sets in easily and healing is slow. Soon there was pus. And pitiable me, I had to change her dressings daily—the stench was beyond belief... far worse than the heaps of dead at Chengmai.

"Diabetes dragged on so long that kidney function was hopeless. After a few more days she was finished. By the time they moved her bed for her last breath, she was already unconscious—at least she was spared some pain. When I went to lay out the body, she was unrecognizable: blank expression, filthy and foul, skin flaking, the bed soaked in pus—a heap of rotting flesh! I imagine even the ghost-judge wrinkling his nose when he came for her—less than a ghost, let alone human. At her end, not a single family member was at her side; she died before us strangers. When the family finally arrived, their faces showed nothing but relief—not a trace of grief. Damn it! Even a corpse on the roadside has parents and children to wail for it!

"At the mortality conference, I said privately to Elder Lin: if I ever end up like that, I'd cut my own throat and go out clean, looking like a human being. Elder Lin just snorted: 'When you reach that point, you won't even be able to open your mouth or eyes. You think you can end it yourself? What makes you so capable?'

"What I mean by 'a drop in the bucket' is precisely this: you fancy yourself snatching souls from the ledger of the dead—but after all our efforts, we've only tugged the ghost-judge's sleeve! Tell me: when death is at the door, what difference is there between the rich and the corpse on the road?"

This speech left Chen Ruihe speechless. Life and death were vast matters; for a young man who had followed his parents into the Council's fold and barely stepped into clinical medicine, this was a topic he had never deeply confronted. He did not want to continue the discussion.

But there was one thing he had been mulling over; he hesitated whether to ask.

"Doctor Xie, do you think... the medic whose one omission cost the County Magistrate a leg—shouldn't he be punished?" At last, as if steeling himself, Chen Ruihe broke the silence.

"By that logic, every one of us here is guilty beyond redemption." Xie Yao pushed his empty bowl aside, unconcerned. "Back when I joined the Council, I served under Elders Zhang, Ning, and He during the Second Counter-Encirclement and Operation Engine—just an assistant to Elder He, really.

(End of Chapter)