Path of Medicine With a System
chapter-254-30041322

Modernization brought along countless conveniences, such as supermarkets and restaurants which were open 24 hours a day, or lights which would forever be turned on at nighttime. These were all evidence of a modernized country’s advancement.

Even in China’s rural villages, a large number of paved roads had been constructed. Dirt roads which would always turn extremely muddy in the rain were now a thing of the past. Highways were everywhere. Even though there was a distance of more than 100 kilometers from the small city hospital to the bigger Chasu City, the ambulance was able to swiftly go down the highway!

Although there was a speed limit on the highway, in China, special vehicles like ambulances didn’t have to obey the speed limit. The ambulances that China’s government issued to smaller city hospitals were all of good quality and had complete medical equipment! Some large-scale ambulances were even capable of acting as mobile platforms in which some emergency surgeries could be performed.

It took only 40ish minutes for the ambulance to arrive at Chasu City Hospital. What an amazing speed! However, the three nomads who were used to riding horses all became carsick! They were all really strong and muscular, yet all three of them vomited! They vomited lots of white milk all over the ambulance. It smelled like it was half fermented. Plus, there was heating inside the ambulance. The emergency nurse in the ambulance really wanted to cut off her nose!

Everything in China would slow down during the Spring Festival. Supermarkets and restaurants would be closed. The government would also be shut down. Every family would be enjoying the festive atmosphere as the Spring Festival was the biggest holiday in all of China.

On the third day of the Spring Festival, Zhang Fan was working a 24-hour shift at the infectious diseases department. Still, he would be paid extra for overtime during the holiday! His salary would be twice the normal amount. Although Chinese law stipulated that people be paid 3x the regular salary for overtime work during any holiday, people who really expected that would be naïve.

Normally, Chasu City Hospital would always be really busy, but during this time, there were incredibly few patients. All of the doctors were taking turns resting. The hospital had also stopped providing outpatient services during this time. All elective surgeries would be scheduled for after the Spring Festival was over. However, the emergency department’s lights would forever be on.

In the emergency department, there was a special machine at the front desk that would beep extremely loudly whenever an ambulance was about to arrive with an emergency patient. The emergency department’s doctors and nurses were currently eating lunch, but they all gathered together and simultaneously put down their chopsticks when they heard this beeping. They put on their caps and face masks in order to prepare to receive the patient.

This author doesn’t know about other industries, but in the medical field, the hospital superintendent and department director were highly important positions. While the Chinese government was indeed greatly supporting hospitals’ development, if there was a problem with the hospital leadership, then the government’s money would likely go to waste.

The hospital and its departments would also depend on the department members to all work hard together. But, if the path was chosen wrongly by the hospital leadership, then either all efforts would be wasted, or things would be really inefficient.

The emergency department at a major hospital would be a treatment center that combined diagnosis and treatment. Some emergency surgeries would directly be performed in the emergency department. If the emergency department was led by a powerful director, then that director would be capable of monopolizing many traumatic injury orthopedic surgeries and general surgeries.

However, Chasu City Hospital’s emergency department director had originally been a pediatrician. She was unable to obtain the position of pediatrics director, being unable to compete successfully with the current pediatrics director. Thus, she moved over to take the position of emergency department director that nobody else wanted. Pediatrics usually focused more on internal medicine specialties. There would be very few professional pediatric surgeons.

This was the weakness of older doctors in China’s medical system. The older doctors weren’t well developed in an overall manner. The emergency department director still had a pediatrician’s way of thinking even though she now led the emergency department. China’s government was greatly supporting the development of emergency treatment, but Chasu City Hospital’s emergency department hadn’t developed any surgeries at all. The most major surgical treatment they could provide was sewing sutures. If the injury was too severe or too deep, the emergency department would simply send the patient to the relevant department. This meant that its efficiency at providing immediate and emergency treatment for patients where every second mattered would be really low.

The only real specialty that the emergency department had under her leadership was performing gastric lavage, also known as stomach pumping.

Back before the 1990s, anyone who drank an insecticide to commit suicide wouldn’t need to be brought to the hospital. They would die before any treatment was possible! Pesticides in China back then were all really strong. For example, dichlorvos, also known as DDVP insecticide, would kill you within three steps if you drank it! It would be impossible for anyone to save you.

Nowadays, there were more regulations on insecticides, so insecticides were now weaker than before. To be quite blunt, if you drank an insecticide in the year 2010, you likely wouldn’t die right away, but you would be in great pain. You would be brought over to the hospital for stomach pumping.

If the insecticide was a weak acid or some compound that wouldn’t react with alkali, then it would be really painful for you. Soap water would be used! The hospital’s soap water wouldn’t be anything grand. It would be the same common type of soap that people would wash clothes with. After dissolving the soap water, it would directly be forcibly injected into the stomach in a large amount in order to induce powerful vomiting. You would feel as if you were vomiting up your gall bladder. Stomach pumping would be as painful as torture.

Normally, those who tried to commit suicide by insecticide would be housewives. After being saved by stomach pumping once, they would no longer try to drink insecticide again, because stomach pumping was far too painful. It would make them never want to see soap again in their lives!

Ake was brought to the emergency department. His emergency routine blood test showed no abnormalities. He had already received basic treatment at the smaller city hospital.

Many illnesses, especially stomach problems, would greatly resemble each other. If the routine tests didn’t come back with a positive identification, then it really would be difficult to diagnose the patient’s problem.

If a doctor was capable of diagnosing a rare disease that wasn’t seen often, then either this doctor had recently diagnosed someone with similar symptoms, or the doctor had previously experienced the same disease themselves before! The rarest situation of all was that the doctor was truly amazing. Normally, a doctor would require some time in order to accurately diagnose an illness.

Relying on symptoms? Many illnesses would have incredibly similar symptoms. For instance, if you had a fever, maybe you would take some standard fever medicine at home, and a smaller hospital would give you some antibiotics. All of this would actually interfere with being able to accurately diagnose the true problem. Without practical clinical experience, even a doctorate degree student looking at their textbook would be unable to accurately diagnose your problem.

Ake was currently in such a situation! Still, the emergency department had its own way of dealing with this. Since they were unable to identify his problem, they would simply summon doctors from other hospital departments over to diagnose the patient!

Since it was the Spring Festival holiday, none of the department directors and veteran doctors were on duty, unless the department was really tiny and lacked personnel. When the emergency department summoned other departments’ doctors over for a consultation, only young doctors arrived! Young doctors would be made to work overtime over the veteran doctors who would instead enjoy their holiday. Well, this was simply how any workplace was. Those who were younger and less experienced would always be made to do more work.

The doctors from the respiratory department and general surgery department looked over the patient for quite a while, but were unable to identify the patient’s problem. A physical examination for the patient had determined that Ake’s fever was at 40 degrees Celsius, and that he had some skin macules on his body. However, his pulse and blood pressure were quite normal. This really puzzled the young doctors. What illness could this possibly be? Other checkup results wouldn’t be out so swiftly.

What could be done? It was quite simple. The emergency department would summon more doctors from other departments over! It was the Spring Festival, so most of the doctors were quite free right now. Since the emergency department was busy, they wanted to make other doctors busy as well! Come! Discuss the patient’s condition together! None of the directors were around, but the young generation of doctors all gathered at the emergency department.

Although China’s medical system wasn’t the best in the world, China indeed controlled infectious diseases quite strictly. The younger doctors had only seen infectious diseases in textbooks before. However, textbooks would only show the most classical examples of infectious diseases. For doctors who had never seen such an infectious disease in real life before, they would be incapable of accurately diagnosing the infectious disease. Not being able to identify the disease meant that it would be impossible to treat it. Although diseases seemed like they should be simple to identify, the human body was incredibly complex, and there were far, far too many similar illnesses. With current medical knowledge, it was still impossible to completely accurately diagnose all illnesses. Oftentimes, only treating the symptoms would be possible.

Now then, why must infectious diseases be controlled severely?

To give an example: cholera! China classified only two infectious diseases as the most dangerous Class A infectious diseases. Those would be cholera and bubonic plague. How vicious was cholera? It would be caused by the vibrio cholerae bacteria. This bacteria was far too powerful. Normal bacteria that entered the stomach would be killed by stomach acid, yet the vibrio cholerae bacteria wasn’t afraid of stomach acid at all.

The cholera bacteria would pass through the stomach and into the intestines, where it would directly start causing the intestines to spasm and convulse, making the cholera victim start having violent diarrhea and vomiting. How violent was the vomiting? To describe it very bluntly, it was as if you were spewing your vomit all over the place. Not only that, your vomit was already digested food that came from your intestines! This was different from how normal vomit would be stomach contents.

As for the violent diarrhea, it would be so severe that it would be impossible for you to control. For cholera patients, it would be no exaggeration to say that two buckets would be required by the patient bed. One bucket would be used for vomit, and another bucket would be placed right under the butt! The diarrhea would be extremely watery, and after a while, you would literally start to poop nothing but water. All of this water was coming from your body!

Just describing this process might not be enough to sufficiently realize how powerful cholera was. Cholera was tremendously powerful. A cholera patient would suffer immense dehydration. How ridiculous was this dehydration? A person who weighed 50 kilograms would lose literally more than 25 kilograms of weight in water in just a single day! This was no exaggeration at all! Cholera was capable of killing within just hours!

Was this scary? Even scarier was that there was no medicine which would directly be effective against cholera. To explain simply, even if a cholera patient was brought to the hospital, the hospital would only be capable of helping you rehydrate. The hospital would have to help you rehydrate as quickly as possible. This was just like a race to see who was faster. If the cholera patient lost water through diarrhea at a faster rate than they could be rehydrated, then there would be no saving them. It would really depend on the patient themselves. They would be lucky to survive! If the cholera patient wasn’t lucky and died, they would instantly be cremated! The family members wouldn’t even be allowed to see the cholera victim one last time!

Another frightening thing about cholera was that it was extremely infectious. If even one instance of cholera appeared anywhere, the first step would be to control the water source in that location. This was because cholera could swiftly pollute a water source. Cholera would spread through food and water. If proper precautions weren’t taken, then cholera would spread in a large area and also kill a large number of people. This was the scariness of a Class A infectious disease!

The infectious diseases department was its own independent department. However, medical knowledge was universal to all departments. Zhang Fan had a personal habit that whenever he was rotated to a new department: he would always grind and learn the main illnesses relevant to this department, even if his System hadn’t opened up specific courses related to the department yet. This was all a part of his quest to always learn more knowledge. It was only natural that he would become so highly skilled with how hard he worked after gaining his System!

Since the emergency department was now summoning doctors from all departments over to diagnose the patient, of course Zhang Fan would go as well. But since the infectious diseases department was far away from the other hospital buildings in the most distant corner of the hospital ground, he was the last to arrive. When he arrived, other young doctors were chatting among themselves about the patient’s condition, but not a single one of them was able to say that they could accurately diagnose the patient’s illness.

“Everyone, make way, and allow our Director Zhang to take a look!” a graduate student doctor who had just arrived this year spoke up. He sounded like he was praising Zhang Fan, but his tone was rather unnatural, making it obvious that he was trying to give Zhang Fan a hard time. He was probably jealous of Zhang Fan!

The current Zhang Fan wouldn’t bother to care about others like this young doctor. That was because Zhang Fan already knew that he was far above them in skill level, so there wasn’t much meaning in caring what a young doctor said. It wasn’t like all the young doctors were like this one. There were too many others out there in the world for Zhang Fan to have the time to care.

“Brother Zhang, here, take a look! The respiratory department won’t take him, nor will the gastrointestinal department accept him. However, the patient’s really burning up with a high fever. We in the emergency department don’t know what to do at all. If there’s no other way, I’ll have to call the emergency department director!” Doctor Li from the emergency department hurriedly gave the patient’s medical information over to Zhang Fan.

Zhang Fan checked the patient’s temperature, the nurse’s records of the patient’s vitals, and then pulled open Ake’s clothes. Zhang Fan used one hand to check Ake’s pulse, while he used his other hand to look at Ake’s chest.

In just 30 seconds, a short 30 seconds, Zhang Fan told Doctor Li, “Report this to the Bureau of Health! This is a Class B infectious disease!” His announcement caused all of the other doctors to reflexively take three steps back!

“Are you really certain? Don’t just make things up. The lab test results haven’t even come back yet. Yet, you’re that certain of your diagnosis? Reporting this means that this won’t be a small matter at all. The entire hospital will be affected,” said the graduate student doctor from earlier. He was rather unhappy because of how Zhang Fan had ignored him.

Zhang Fan turned around angrily because this graduate student was testing his limits. Zhang Fan threw the patient’s medical information sheets right at him. “This is typhoid fever! The symptoms are skin macules! A relatively normal pulse! And a high fever! Just how did you even manage to graduate medical school!?”

Zhang Fan didn’t waste any more time with the graduate student doctor as he turned around to tell Doctor Li, “Perform a Widal test! (A Widal test is a test to determine typhoid fever.) Blood culture! Immediately bring the patient to the infectious diseases department!”

“Okay! I’ll make the preparations right now. Brother Zhang, will you report this to the Bureau of Health, or should I?”

“You’re the first doctor here to receive this patient. If you don’t want to, then I’ll go report it.”

“Look at what you’re saying. I was just worried about stealing your credit. I’m not like some certain people. Okay, I’ll go report it right now!”

“Doctor Zhang, you’re amazing!”

“I know! He identified the problem instantly!”

Zhang Fan was now receiving a lot of praise from the other young doctors. The graduate student doctor from earlier felt really awkward as he held on to the patient’s medical information sheets! Although Zhang Fan had said only a few words to him, those few words had given him a serious impact! He really regretted challenging Zhang Fan in front of so many people now!