Chapter 2824 Grand Rounds
"You're right." Dingding couldn't help feeling deflated.
"This is merely my personal perspective—naturally, you should seek cooperation from other departments, but you ought to leverage your own unit's resources as well..." He waved his hand to forestall interruption. "I know what you're about to say: that you're just paper-pushers with nothing to offer. But actually, your resources are far from negligible. All our mouthpieces rest in your hands—how can you claim to have nothing?"
"That may be true in theory, but the authority to set propaganda policy doesn't belong to me." Dingding was equally forthright. "Everyone calls me Goebbels, but what kind of Propaganda Minister am I really? I can't even decide which stories to run—every decision must go through Senate meetings..."
"You can't look at it that way." Ma Qianzhu habitually drew out his words. "Newspapers, magazines—these are gold mines waiting to be tapped. You should explore their potential value more thoroughly. I imagine many departments and institutions would welcome the chance to have their work discovered and understood by the public..."
If there were an election for most respected Senator, Shi Niaoren would surely find himself in second place, gazing upward at first. Feudal honorifics like "Divine Healer," "Medicine King," and "Medical Immortal" could no longer capture his standing. According to his own ambitions, every therapeutic prefix in the Australian Medicine textbooks could rightfully bear his name. Of course, this was impossible—at minimum, half the naming rights would have to be ceded to the other livestock-raising Senators.
At this moment, it was the weekly Shi Niaoren Time: the Bairen General Hospital inpatient department grand rounds. Ever since this system was established, the livestock-raising Senators privately referred to it as "Senator Shi Holding Court."
Dr. Shi hadn't initially realized his grand rounds carried such significance. But as the Health Department and Bairen General Hospital expanded in scale and medical personnel multiplied—through both deliberate effort and organic growth among naturalized-citizen medical staff—these rounds took on an increasingly ritualistic quality.
Every Monday morning, grand rounds commenced with a high-pitched announcement from Zhang Ziyi, Lingao General Hospital's Nursing Director and Chief Nurse: "Dr. Shi's rounds!"
At this call, every ward immediately fell into wordless tension. Head nurses, duty nurses, and attending physicians scrambled to adjust their appearances, then parted to either side, lining the corridor in precise order according to education, seniority, and rank.
As the fifth-floor elevator doors of the inpatient building slowly opened—the newly constructed Bairen General Hospital had been equipped with elevators to accommodate patient transport—Shi Niaoren's modest figure appeared at the corridor's end. Fu Qiliang and several other Senator physicians immediately gathered around, offering greetings with familiar warmth: "Good morning, Dr. Shi!" Within the hospital, everyone preferred the title "Director" to "Minister." After all, it felt warmer—more like addressing one of their own.
After Shi Niaoren exchanged pleasantries with his fellow Senator physicians, he began his procession down the corridor. Scores of naturalized-citizen doctors stood stiffly on either side, their expressions taut with apprehension, alongside an even larger contingent of female nurses. Together, they bowed in unison, welcoming the Senator physician into the ward. The scene never failed to remind Shi Niaoren of emperors setting forth in historical costume dramas—which was precisely why he never tired of it.
In truth, he merely cast casual glances into the ward rooms. Strictly speaking, Shi Niaoren wasn't exactly an authority on conventional hospital departments like surgery or internal medicine; his specialty was infectious diseases. But back then he had been the eldest among them, and his MD from the University of Pennsylvania's Perelman School of Medicine was genuinely impressive—credentials that had earned him sufficient credibility to assume the Health leadership position.
Of course, years of high-intensity work had also rapidly expanded Dr. Shi's clinical experience. It was simply that objective material constraints meant many diseases still couldn't be treated, which left him with some regret. In his own field of infectious diseases, however, Dr. Shi had made considerable professional advances—if his mentor were to traverse here now, he would likely find himself outmatched.
Today's focus was the Combat Injury Ward. Originally, the Health Department had no such discipline. Only after the Mainland Campaign began and casualties surged did this specialty open, at the emphatic recommendation of Senator physicians serving at the front lines.
Bairen General Hospital's Combat Injury Department remained modest in size, since the largest and most specialized facility in this system was the Army General Hospital at Maniao. The Bairen ward existed primarily for research and was headed by Fu Qiliang, who had recently returned from the front.
Today, in the duty doctor classroom, Fu Qiliang was preparing to lecture the residents in training. This was another major innovation of the Senate's health system. After all, their homegrown doctors had studied for too short a time, and the gaps in their knowledge were too numerous—the only viable path was "work while studying."
Though Dr. Shi wasn't particularly invested in this department, as Director, it was his responsibility to pay personal visits.
The classroom was packed, everyone holding their breath and staring intently.
"Let's examine this case." Fu Qiliang switched the transparency on the slide projector. The device was manufactured by the Optical Equipment Factory as a substitute for the projectors they couldn't produce themselves. Its structure was remarkably simple—essentially a powerful light bulb paired with a lens assembly. Its chief advantage was that all supplies could be produced locally.
Cases and photographs were developed onto glass slides. As for text and diagrams, the process was even simpler—they were hand-drawn directly. A well-made set of slides could serve for ten or twenty years.
"Patient Eleven. Male, seventeen years old, gunshot wound to the chest. The fragment entered above the sternum, causing a penetrating neck wound. After emergency hemostasis, he was evacuated to the field hospital. Under field conditions, X-rays couldn't be taken. This is the result of his surgical exploration." Fu Qiliang paused, surveying the room. "Based on this probing, how should we assess this patient's condition? And how should treatment and nursing proceed? Discuss."
A bout of whispering rippled through the room before naturalized-citizen doctors began raising their hands.
"If the carotid artery had been struck, he wouldn't have made it to the field hospital..."
"Since there's no suffocation, the trachea should be intact..."
"The key indicator is whether blood foam is expelled during breathing..."
"There would also be violent coughing..."
"Local cleaning, removal of foreign matter, prevention of airway obstruction..."
Fu Qiliang found himself both gratified and frustrated. Gratified because the naturalized-citizen doctor training was clearly yielding results—especially among those who had served in battlefield rescues. Their proposed treatment plans were presentable; evidently, they had encountered similar wounds before. Frustrated because most still grasped the "what" without understanding the "why"—they couldn't reason from anatomical principles about which tissues occupied that region, what injuries were possible, and then formulate a structured investigative approach.
Fu Qiliang shook his head slightly. He would have to start from fundamentals again. Moving the human anatomy chart to the center of the blackboard, he tapped it with his pointer: "Who can tell me what organs are located in this area?"
Another wave of whispers. The naturalized-citizen doctors' ingrained reluctance to speak frustrated Fu Qiliang immensely. Sometimes they clearly knew the answers but simply didn't dare voice them, preferring instead to exchange opinions privately. Under Fu Qiliang's encouraging gaze—which gradually darkened with impatience—someone finally raised a hand: "Blood vessels, trachea, and esophagus."
"Very good." Fu Qiliang offered appropriate encouragement. "Theoretically, a fragment passing through could injure all three. We must assess them in order of importance. As you've already noted: vascular damage causes major hemorrhaging; tracheal damage causes suffocation. This case happens to involve the third possibility—esophageal damage—which is why the patient was able to survive the two-day journey from Guilin to the hospital. Now that we've identified the injury, who can describe the treatment plan?"
"Double-layer inverted suture..." This time someone's hand shot up quickly.
"If conditions permit, a drainage tube should be placed..."
"Battlefield wounds are rarely simple lacerations. Debridement and tissue trimming are likely necessary..."
"Clear subcutaneous foreign matter, watch for fragments, dirt, necrotic tissue, emergency gauze, and other foreign objects that easily infiltrate wounds..."
Fu Qiliang nodded. Once the theoretical framework was established, the rich clinical experience of those naturalized-citizen doctors who had served on the battlefield began to take effect. This hands-on knowledge was extraordinarily valuable. The practice of "veterans teaching newcomers" relied heavily on these doctors who knew the "what" even if they didn't yet grasp the "why."
"In this case, the patient reached Zhaoqing and underwent esophageal suturing surgery immediately. He is now in post-operative recovery—what nursing protocols should be followed?" Fu Qiliang turned his gaze toward the nurses.
"Timely dressing changes, temperature monitoring, vigilance for post-operative infection..."
"He should be fasting, shouldn't he..."
The nurses were considerably bolder than the naturalized-citizen doctors. Daily patient care had made their personalities far more forthright. Moreover, Senator Fu Qiliang was rather handsome—second only to Dr. Hippo, who had departed for Sanya. And Dr. Hippo's first wife had been a nurse just like them, so...
Fu Qiliang smiled, acknowledging both the nurses' answers and their admiring gazes.
"Following esophageal damage, once leakage occurs, the strongly irritating gastric contents—along with bacteria-laden oral secretions and food—rapidly enter the mediastinum through the breach, causing severe mediastinal infection. Moreover, because the mediastinum consists of loose connective tissue, and due to negative pressure and cardiac pulsation, inflammation spreads with alarming speed, potentially eroding through the pleura into the thoracic cavity..." He paused gravely. "In short, the consequences are extremely serious. Therefore, such patients must maintain a seated posture, with strict fasting and no water intake, to minimize the risk of esophageal leakage."
"This patient ultimately did not survive. Despite receiving sulfonamide anti-inflammatory drugs, he died of severe purulent mediastinitis. I didn't have time to perform an autopsy to determine the precise cause, but through inquiry, I can essentially confirm the primary factor: infection caused by the patient eating aboard the medical ship, which triggered mediastinitis before surgery could be performed." Fu Qiliang's voice grew heavy. "Regrettably, this young man survived Ming army artillery fire only to be killed by field ration crackers. I want everyone to remember this lesson well."
(End of Chapter)