Chapter 107: Chapter 107 - 0105: Charity Surgery

After visiting Teacher Yan’s ward, I went to visit a young man with osteomyelitis.

Yang Ping asked the duty doctor to bring the dressing kit, and she personally changed the dressing, measuring the area of skin defect.

“I was fine after the surgery, but three months later a lump formed here, then it broke, becoming an open wound, and ever since it has been continuously discharging pus.” the young man explained.

“You’ve undergone several surgeries, haven’t you?” Yang Ping conversed with him while changing the dressing.

“Yes, I’ve had several debridement surgeries, some skin was cut off, some flesh too, a piece of bone removed, since the metal nail had surfaced, the doctor didn’t dare to meddle with the bone anymore, they said it’s all infected now, more cuts wouldn’t do any good. I originally wanted to join the army, but now this has happened…” The young man appeared very dispirited, his dream had been obliterated.

Being in the army, even if his osteomyelitis was cured, his hyperthyroidism would prevent him from enlisting. The path to being a military man was no longer possible.

After dressing the wound, Yang Ping said, “We’re trying to figure out the best treatment, though it will be a tough process. We took a bone sample for testing today, and we will need to get some blood samples tomorrow morning. Once we have the results, we will examine your condition further.”

“If I get cured, can I still be a soldier? They say that for the rest of my life my leg will remain like this, unless it gets amputated…” the young man seemed pessimistic.

“Rest well these few days, don’t worry too much, there are more solutions than problems.” Yang Ping comforted him.

“Yes, I have to become a soldier.” The young man’s dream of joining the army was very strong.

“There are many other professions you can choose from, doesn’t have to be the army,” Yang Ping tried to console him.

“Doctor, as long as I can get cured to the point where I can join the army, I wouldn’t mind how many surgeries it takes. I’m sure you’ll find a way.” He looked up to the doctor with hopeful eyes.

“I’ll try my best!” Reassured Yang Ping.

At this moment, an elderly couple entered the premises, bringing food in a thermal lunch box. Klthough nearly eighty, they seemed to be in good health and had no need to walk with a cane.

After changing the dressing, Yang Ping noticed Director Zeng had been waiting by the door the whole time, and wondered if there was something he wanted.

It turned out he wanted to treat Yang Ping and the others in the ward to dinner, including all the doctors except those who were on duty.

Initially, he had intended to invite everyone a day later, but learned that Yang Ping and others had to go on a rural outreach mission in two days. He was worried that any further delay would make the invitation seem insincere.

So, he decided to take them out for dinner that same day at a restaurant near the hospital.

The attending doctor helped clean up the trash.

Everyone went to dinner together, a short walk away.

During the feast, everyone was in high spirits. Director Zeng expressed his usual grievances about the various difficulties of running a rural hospital.

Talking about the young man with osteomyelitis, his face grew troubled.

The young man’s surname was Xu, he was actually quite pitiable. Both his parents died when he was young and he was raised by his grandparents who are now in their eighties.

Because the treatment for chronic osteomyelitis takes a long time and is very costly, even with health insurance, the out-of-pocket expenses are unbearable. To afford his treatment, the elderly couple sold their only house and now live in an old bungalow belonging to a relative.

What Director Zeng said on his ward round that morning contradicted what he just said.

Zhang Lin seemed about to say something, Yang Ping immediately said, “Zhang Lin, can you pour me a drink?”

Zhang Lin understood and refrained from making anyone uncomfortable.

Yang Ping knew, that when Director Zeng spoke the way he did on the first day, it was only to caution them against making rash decisions. Director Zeng had misunderstood.

“Given the situation, cost is an issue, we need to think of a solution.” Yang Ping brought attention to the very real problem.

Expecting the hospital to foot the bill? If every case like this had to be paid for by the hospital, it would go bankrupt.

This Sanbo’s medical outreach is a charity activity, but it merely entails volunteer work by Sanbo’s doctors.

Yang Ping and Director Zeng started doing the math on the cost, assuming the test results confirm the prognosis, surgery is possible.

The intramedullary nails need to be removed, replaced with an external frame. The bone defect needs to be filled with antibiotic-containing calcium sulfate, which is even more expensive than gold and if calculated by the gram, is estimated to cost thirty to forty thousand yuan, just for this consumable alone.

Even if health insurance covers a part of the cost, he would still have to bear at least over ten thousand yuan.

Asking the equipment dealer to sponsor some materials could be an option, but since the rural county hospital would have lesser usage, they may not be willing, especially with regards to the calcium sulfate, as Director Zeng surely wouldn’t use much of it all year round.

Doing business, essentially, means making money. Asking someone for sponsorship means the cost is absorbed by the sponsor’s customer base; since Zeng himself rarely used the product, why would anyone agree to sponsor it?

Director Zeng was distressed about this issue; this was more formidable than Teacher Yan’s problem.

Yang Ping took a sip of his drink and proposed, “The bulk of the cost for this surgery stems from the external frame and calcium sulfate, I’ll figure something out.”

Once Yang Ping said this, Director Zeng felt at ease; the issue of cost was resolved.

No one drank any alcohol for fear of an emergency. With a staff shortage in the small hospital, there were even fewer people who could perform surgeries.

Unlike at Sanbo Hospital, where the surgery doesn’t get delayed even if all directors are not operating, because there are experienced attending doctors like Dr. Jin, who can handle surgeries without any fuss.

After dinner, they returned to their quarters. Director Tian came back relatively early today, having no socializing to do.

He gave a list to Zhang Lin, “The weather has been quite nice these days, there’s an outreach activity in the rural areas. You and Little Five take care of assigning personnel, the ones in circles don’t need to go. Notify everyone to meet in the hospital meeting room tomorrow noon. We will leave the day after for the activity, which will take a whole day. We will set off early in the morning and return in the evening.”

Zhang Lin took the list and asked, “Aren’t we already in the countryside? More rural outreach? How much further can we go?”

“Go into the mountains and villages, deliver medical services and medicines, conduct physical examinations and treat diseases,” Director Tian said.

“For how long?”

“One day, a total of ten villages, all of which are minority ethnic settlements. Village doctors and village officials will guide the entire way,” Director Tian said.

“That’s not bad, we should do it for several more days, for a week,” Zhang Lin said with delight.

Director Tian glanced at him and said, “Are you here for rural assistance or for a vacation?”

“Both poetry and mundane life are important, Director Tian! This is called the spirit of revolutionary optimism.”

Zhang Lin began to sketch on paper with a pen.

Liang Fatty asked, “Am I going too? Am I delivering anesthesia?”

“No need for you to risk your neck, your job is to measure blood pressure. Aren’t you trying to lose weight? Walking up and down the mountain roads, I guarantee you’ll lose five kilos. If you carry all your luggage, it’s not impossible to lose ten kilos,” Director Tian said leisurely.

Whenever Director Tian was free, Yang Ping would speak up: “Director Tian, there is something I need to report to you.”

Yang Ping had briefly reported on the patient with chronic osteomyelitis earlier. Now he needed a detailed report. Speaking of calcium sulfate and an external fixator, Yang Ping said Director Zeng wanted to find a supplier to solve the problem, but there would definitely be difficulties.

After thinking for a moment, Director Tian said: “They don’t use it much, how could anyone sponsor them? Losing now is for earning more in the future. I’ll take care of this. How much calcium sulfate would we roughly need?”

“At least thirty grams,” Yang Ping estimated.

Director Tian immediately picked up the phone: “Xiao Lin, this is Tian Yuan, I have a charitable surgery at Nanqiao County People’s Hospital, I need thirty grams of calcium sulfate, I will send you the address, please send it over as soon as possible, urgently needed. Can it be express shipped tonight? That would be best.”

After hanging up the phone, he dialed another number and solved the issue of the external fixator.

“They will ship it tonight, and it should arrive tomorrow or the day after. It won’t affect the surgery, right? If necessary, I can have them send a special car,” Director Tian was very enthusiastic.

“No need for that, the surgery will certainly be several days from now,” said Yang Ping.

Originally, he was just reporting first, there was no rush for the materials, there was still uncertainty if the surgery would proceed or not. But Director Tian solved everything with just a few minutes and two phone calls.

With the issue of materials solved, the next step was diagnosis. Is the patient’s condition the same as his conjecture? No one can be absolutely sure until the results come out.

With the problem solved, Yang Ping had a good night’s sleep.

Another day passed, the third day of work.

Just when the shift had ended, but before rounds had started, Director Zeng received a call from the Director of the Laboratory Department.

“Thyroid hormone, T3, T4, FT3, FT4, are all elevated, especially T3 and FT3 increased significantly! The thyroid function is truly hyperactive!”

After hanging up the phone, Director Zeng sounded excited, as if he was hoping for the patient’s hyperthyroidism.

If one were to say that an imaging examination was the first piece of evidence.

Then the second piece of evidence already supports his diagnosis.

Now they are just waiting for the third piece of evidence — the bacterial culture! This is the most important piece of evidence, if all the specimens yield cultured bacteria, the previous two pieces of evidence will be overshadowed.

The results of bacterial culture only come out after three to five days, so patience is necessary.

This patient was not like Teacher Yan who could be diagnosed quickly and show immediate changes after surgery. Diagnosis alone for this patient was a troublesome matter.

Now, Teacher Yan was doing well. Except for some slight pain at the surgical site, the previous numb pain in the lower right limb had completely disappeared, and the anticipated aftermath had not occurred.

During rounds, he was on the phone: “Too small, a little bigger, even bigger–”

His son had gone to buy breakfast. A pair of crutches was placed beside the bed. He had wounds on his butt, so it was inconvenient to sit, walking was easier.

Seeing Yang Ping came, he immediately smiled: “I had a good sleep last night, so relaxed. Before, even several tablets of An Ding had no effect on me, just like eating beans. Last night, I intentionally didn’t take An Ding, then unknowingly fell asleep, and when I woke up, it was almost eight o’clock. This is what life should be like.”

After lunch, in the conference room of the hospital, Director Tian and Dean Pan called a small meeting, about carrying out the health services to the rural areas tomorrow.

They selected ten villages, all relatively remote, populated with ethnic minorities. Two to three people were assigned to a village, along with a medical box, to carry out physical examinations and treat the villagers. Doctors from the Traditional Chinese Medicine Hospital and Maternal and Child Health Hospital assigned by Sanbo were not required to participate.

The Health Bureau would send cars to drop people off at the entrance of the village, each team would be accompanied by local village or township officials.

In the afternoon, everyone was to return to their dormitories to prepare.

Yang Ping packed his backpack and checked the weather forecast on his phone. The weather was clear for the next few days, which was quite suitable for going to the countryside.

The rural areas here were the real countryside, with concrete roads only reaching the entrance of the village. The so-called “village entrance” was just a concept, not a geographic location.

The residences here were very dispersed, some mountain roads were completely suspended over cliffs, it’s impossible to build a road there.

“On such a sunny day, why are you packing a raincoat?” Zhang Lin asked, seeing Yang Ping packing a raincoat.

Yang Ping thought that the weather forecast wasn’t always 100% accurate, it’s more comforting to take a raincoat along.

“Preparation beforehand!”

Yang Ping folded up two raincoats.