Chapter 2565 - The Gap
After the examination, Lin Motian was fairly certain Mother Zhang didn't have tuberculosis. More likely it was a common respiratory infection—streptococcus, mycoplasma, something of that nature. Such infections weren't unusual among middle-aged and elderly patients, though hers had lingered too long and grown quite serious. Proper antibiotic treatment would see her recover quickly. Under ancient medical conditions, however, one careless moment and she might well have departed for the Western Paradise.
"Admit her as an inpatient," Lin Motian said, signing the approval on her medical record. Since Mother Zhang was self-paying, hospital policy required payment before admission. Zhang Jiayu obviously couldn't produce the sum, so Lin Motian had to make a special exception—admission on credit.
"You'll need to settle this bill eventually. Otherwise Deng Bojun will see it and start arguing with me again..."
"Wait—he's here too?"
"What do you mean 'too'?" Lin Motian gave a wry smile. "Ever since the plague ended, Section Chief Deng has been stationed permanently at Provincial-Hong Kong General Hospital, rolling out every medical service imaginable... damn! The place is minting money by the bushel every day!"
Zhang Xiao offered a few dry laughs. Though Deng Bojun's primary goal in running Provincial-Hong Kong General Hospital was to generate revenue for the health sector, the chemical enterprises benefited handsomely as well. The pharmaceutical factory had become one of the highest-margin operations among the Planning Commission's state-owned enterprises. Were it not for the massive investment required by incomplete upstream industries—with some raw materials still prohibitively expensive—they could have dropped the "one of" qualifier entirely.
That evening, Zhang Xiao hosted his dinner party in the upscale restaurant atop the Great World guesthouse. The chefs here had all transferred from the Consulate Hotel and received training from Liu Xiang himself, which made the cuisine particularly suited to Elders' tastes. For any Elder visiting Guangzhou, this was a mandatory dining destination.
The guests were fellow Elders from Guangzhou's health sector: Lin Motian, Fu Qiliang, and Deng Bojun from Provincial-Hong Kong General Hospital, along with the visiting Zheng Mingjiang.
Naturally, it was splendid to have someone else picking up the bill. After three rounds of drinks, the group spent a while critiquing the dishes before inevitably drifting back to work—three sentences without straying from their profession.
"Dr. Lin, I reviewed some medical records and prescriptions this afternoon, and something puzzled me." Zheng Mingjiang set down her sparkling water. "Why are you all so stingy with medications? It feels like excessive economy. The Senate may be poor, but not that poor. I noticed you're reluctant to use even sulfonamides and oxytetracycline, let alone penicillin and streptomycin. Even accounting for drug resistance concerns, there's no need to be this miserly."
Lin Motian heaved a long sigh. "You're in Lingao—you don't know how hard it is out here. As the old saying goes, 'with grain in the barn, there's no panic in the heart.' Now go look at our pharmacy. Many drugs don't even have twenty-four hours of basic reserves, and we're constantly running out every few days. How can I not use them sparingly?" He smiled ruefully. "The moment I get back to my desk at end of shift, I get a headache. Every day there are notes from Elders requesting this medicine or that... Yes, looking forty-five degrees up at the sky won't help—I'm talking about exactly your type!" Lin Motian jabbed a finger at Zhang Xiao. "With these note requests, you people play the heroes while we play the villains. Meanwhile, outside, how many patients who've paid and queued are waiting for medication and getting delayed!"
Zhang Xiao could only plaster on a smile and pour him more wine.
"So now I'm telling the doctors to use antibiotics cautiously, especially penicillin and streptomycin—these run out every few days. I'm terrified we'll encounter a patient with a severe infection and have nothing to treat them with. Right now, even oxytetracycline isn't available."
Lin Motian poured himself another glass and continued venting. "Earlier, Liu San saved a man named Yu Qing—he was a promising prospect for medical training. He'd been on the front lines during the plague, helping with epidemic prevention. We'd planned to focus on cultivating him after everything settled down." A shadow passed over his face. "Unfortunately, he got infected on the front lines. Couldn't save him. You know, if I'd had just one box of streptomycin, I could have saved his life. Even tetracycline or oxytetracycline would have worked. But I didn't have a single box. All I had on hand was sulfonamide."
Zhang Xiao found this strange. "Before the plague, I was running small-scale research trials on streptomycin. Previously, due to the Planning Commission's annual plan, we'd been pushing the penicillin project. After the plague hit, we urgently switched to tetracycline and streptomycin. Still, oxytetracycline went into production long ago—surely there couldn't have been none at all?"
Lin Motian considered this. "Could it have been allocated to the front-line troops? War burns through money and materials."
"I was doing battlefield medical work at the front," Fu Qiliang explained. "With the lines under pressure, it was probably all going to the Bobo Army."
"The Senate has always been short of everything," Lin Motian said. "Whatever we do, we're stretched thin—always scraping things together. And didn't you say streptomycin capacity was just a fraction of a ton?"
"Now, now, my dear Director Lin—let me break down our inventory for you." When it came to pharmaceutical capacity, Zhang Xiao didn't just know the details; he knew them inside out. "After our factory went into production, sulfadiazine annual capacity hit twenty tons—I designed that line myself. Add in various other sulfonamide varieties, and thirty tons a year is no problem. Streptomycin is a bit less, but still five or six hundred kilograms annually. Tetracycline is essentially an upgraded oxytetracycline production line—by changing the additives in the fermentation process, you can also get chlortetracycline. Since oxytetracycline and chlortetracycline both serve human and veterinary medicine, production volumes are massive. Only the penicillin project gave way to streptomycin, but it was in production before I left—outputting a ton a year is no problem."
He ticked them off on his fingers. "The four major varieties used most after the People's Republic was founded—oxy, tetra, peni, strep—I've assembled them all for you. Though raw material and equipment issues have caused production to fluctuate, never able to run at stable full capacity, even at our worst we maintained fifty percent. That shouldn't have left you this strapped."
Deng Bojun shot Zhang Xiao an admiring look, his mental abacus clicking away. "Sulfonamides can basically be used freely. Once the four major antibiotics scale up, Provincial-Hong Kong General Hospital will be a beacon of humanity. All that gleaming white silver..."
"Your capacity hasn't come up yet," Lin Motian said. Fu Qiliang nodded in agreement. "And anyway, a few hundred kilograms here, a ton or two there—feels like it's not even enough to fill the gaps between teeth."
"A fraction of a ton is actually quite significant," Zheng Mingjiang reminded them. "A hundred thousand units of penicillin is only 0.6 grams, and streptomycin is just one gram."
"Let me put this in perspective," Zhang Xiao said. "In 1943, the Americans had only about a ton of annual penicillin capacity, and that was enough for the entire Far East allied forces. Compared to the scale of WWII's Far Eastern theater, the Bobo Army is practically a shrimp. Don't carry over your old timeline habit of casually using millions or tens of millions of units per dose. During WWII, a hundred thousand units per injection was considered a lot. What we're commonly producing now is ten thousand unit doses."
He went on to lay out the accounting. The factory's drug output operated on two price tiers. First was the "internal transfer price," set by the Planning Commission and allocated to hospitals, clinics, and other institutions under the health sector—mainly supplying publicly-funded medical care for naturalized citizen workers, military personnel, and their families. Second was the "commercial wholesale price," purchased by the state pharmaceutical company as sole distributor, then wholesaled out. Customers here were mainly large private pharmacies like Runshi Hall and Chen Liji. Additionally, public medical institutions like Provincial-Hong Kong General Hospital also purchased some drugs through this channel for self-paying outpatient services.
"Currently about a third of the factory's capacity goes through internal transfer, and two-thirds through commercial wholesale. I don't know your hospital's specific purchase volume, but in absolute numbers it's definitely not small—you're ranked second on the pharmaceutical company's customer sales list, and fifth on our factory's transfer channel ranking, behind only Joint Logistics, Land Reclamation, Nanyang Company, and Lingao General Hospital."
"There's a problem here," Zheng Mingjiang concluded.
Everyone's gaze immediately fell on Deng Bojun.
Seeing the suspicious looks, Deng Bojun quickly defended himself. "What are you looking at me for? All drug movements are recorded! How much comes in through which channel, how much goes out—every step has receipts and documentation. One audit will reveal everything."
"I also feel the problem probably isn't on our end," Lin Motian said. "Drug receipts are reported to me daily, along with settlement documents. Though I don't examine every one, I do regular spot checks. And I trust Old Deng—after all, Provincial-Hong Kong General Hospital was originally..." He paused. "Anyway, I think the problem probably lies elsewhere."
With Lin Motian backing him, no one could probe further in that direction.
"Now that you mention it, something comes to mind." Fu Qiliang leaned forward. "A while back, there was something on the market called 'Lushi Powder,' supposedly the ancestral secret formula of some mountain hermit. Claimed to treat all kinds of redness, swelling, heat, and pain—sword wounds, even another plague, it would cure it right up. I originally dismissed it as quackery, but I heard the effects were actually quite good. It's rare for a traditional Chinese medicine preparation to effectively fight infection. I'd thought about getting a sample to test the ingredients, but got too busy and let it drop." He frowned. "Now that I think about it, this might not be so simple."
"There's more," Zhang Xiao added. "Zhang Jiayu bought two oxytetracycline tablets from some traveling doctor for the exorbitant price of one tael of silver."
Zheng Mingjiang pulled out her little notebook and jotted this down. "I'll look into it when I have time. Since I've stumbled onto this, there's no reason to leave empty-handed."
"Director Zheng, you have my full support!" Zhang Xiao thought of his previously embezzled prize and grew so incensed his Sichuan dialect came out. "Investigate thoroughly! These bastards need a beating! Do you all remember two years ago when the State Council organized that video editing competition among Elders? I originally didn't have time for it, but when every other department was participating enthusiastically, I figured someone from the medical sector should represent us. So I edited a short film for the health sector called The Senate's Medical Enterprise..."
"Mm-hmm, I remember," Deng Bojun said. "It even won second prize. You're the pride of our health sector."
"What health sector pride—I really did get 'cleared out!'" Zhang Xiao exclaimed, full of grievances.
(End of Chapter)