The group continued their rounds.

This time, it was no longer a one-man show for Li Xu.

Eager to save face and showcase his abilities, Yamada was extremely focused.

Indeed, Yamada proved himself worthy of his title as a professor at Tokyo University’s medical school. He was genuinely skilled.

When examining several patients with chronic illnesses, Yamada employed the four traditional diagnostic methods. He combined this with his precise interpretation of Western medical test results, leading to exceptionally accurate diagnoses. The Traditional Chinese Medicine granule formulas he prescribed were methodical and rigorous, promising excellent results.

This earned him nods of approval from the doctors watching on.

Japan’s Traditional Chinese Medicine was indeed well-developed in terms of standardization and regulation. It held a unique advantage in managing common and chronic illnesses.

In contrast, the skills of Caballo and the others seemed rather inadequate.

Although they were experts in their own countries, their skills in Chinese medicine—and even in some complex internal medicine diagnoses—were comparable to those of an average attending physician at a municipal hospital.

Next to masters like Li Xu and Yamada, they were reduced to being mere background props, the ones shouting "bravo" from the sidelines.

The morning’s exchange concluded in an atmosphere charged with astonishment and learning.

But for Yamada, this was only the beginning.

Before his arrival, Fujiwara and Ishijima had instructed him to uncover Li Xu’s secrets.

Yamada believed Li Xu had no secrets.

It was purely a matter of immense skill.

With such incredible skill, developing a few formulas was perfectly normal.

’Mr. Fujiwara, Mr. Ishijima...’

Yamada silently recited his two friends’ names. ’The opponent you’ve encountered is likely a hundred times more formidable than you imagine...’

...

At lunchtime, a lavish working lunch was served.

But no one was paying much attention to the food.

Their conversation still revolved around the morning’s medical cases.

Though Yamada appeared calm, the competitive fire within him burned ever brighter.

Being outshone by Li Xu that morning left him, a professor from Tokyo University, feeling quite frustrated.

He desperately needed an opportunity, a chance to display his true abilities.

Just then, Dean Song’s phone rang. It was the director of the emergency department, and his voice was rushed.

"Dean Song, we have a critical patient in the ER. The situation is extremely complex. Our experts are consulting on it now, but... we’re honestly not confident. Could you ask the experts from the international delegation and Doctor Li to come take a look?"

Dean Song lowered his phone and looked at the group. "There’s an emergency case in the ER. It’s a very unusual situation. Would anyone be interested in taking a look?"

Yamada’s eyes lit up. He immediately set down his teacup and stood up. "Of course. Emergency medicine is the ultimate test of a doctor’s skill. We are duty-bound to assist."

He was fired up. ’This morning’s case was a severe one purely within the realm of traditional internal medicine. Maybe Li Xu just got lucky.’

’But an emergency, a sudden crisis like this, often requires a multidisciplinary approach. I refuse to believe Li Xu can be an expert in everything.’

Li Xu, naturally, had no objections either.

He was also curious to see what kind of case had left the entire emergency department at a loss.

The group strode quickly toward the emergency building.

Lin Guorui and the other key doctors from the Hospital of Traditional Chinese Medicine followed close behind. An on-the-spot teaching opportunity like this was a once-in-a-lifetime chance.

Upon arriving at the emergency resuscitation room, the atmosphere was noticeably more oppressive than in the inpatient wards.

The alarms of various machines beeped incessantly, and the air was thick with the mixed scent of disinfectant and blood.

On the bed lay a young female patient. Her face was ashen, her lips were cyanotic, and her breathing was weak and shallow. The rise and fall of her chest was wildly irregular.

The director of the emergency department, his brow beaded with sweat, rushed over and handed them a thick file. "The patient’s name is Zhao Qingya, twenty-two years old. She had a sudden fainting spell at home half an hour ago and was already in shock by the time she arrived."

His voice was grave as he explained her condition.

"This patient’s case is highly unusual. She has a five-year history of severe depression and has been on long-term antidepressants. Her overall physical condition was already quite poor."

"To make matters worse, she has a complex congenital heart defect—Tetralogy of Fallot. Although she underwent palliative surgery as a child, the strain on her heart has grown heavier with age."

"But that’s not even the most hopeless part..."

The ER director pointed to a recent CT scan. "Two years ago, she was diagnosed with a malignant lung tumor. It was early stage, but she was too weak for surgery, so she could only receive conservative treatment. Now, the tumor has metastasized, and it has spread to a very difficult location—it’s invaded the mediastinum, is compressing the superior vena cava, and is even starting to encase the heart’s great vessels."

"Her fainting spell just now was caused by cardiac tamponade from the tumor’s pressure, compounded by heart failure triggered by emotional distress."

The director finished and sighed helplessly.

The depression destroyed her will to live, the congenital heart disease weakened her physical constitution, and the lung tumor was a ticking time bomb.

Combined, the three conditions created an impossible, unsolvable deadlock.

It was like a building with a rotting foundation and broken pillars being hit by an earthquake.

Want to treat her heart?

The tumor is compressing the blood vessels, making surgery impossible.

Want to treat the tumor?

Her heart could stop at any second. Chemotherapy and radiation are out of the question; her body simply couldn’t withstand them.

Want to build up her physical strength?

Her depression causes chronic loss of appetite and insomnia, so there’s no way to provide nutritional support.

It was a perfect, closed-loop deadlock.

After hearing the explanation, Yamada was utterly stunned.

He had wanted to show off his skills; he had even formulated several emergency treatment plans in his mind.

But in the face of this case, all his plans seemed as laughable as a child’s toys.

’Show off my skills?’

’I feel more like chopping my own hands off!’

Lin Guorui and the other department directors glanced at one another, their expressions filled with helplessness.

From a medical ethics standpoint, this was the kind of patient for whom "further aggressive treatment is not recommended."

"What do we do?"

The ER director looked at Dean Song and the assembled experts. "Her blood pressure is only being maintained by high-dose vasopressors. Her heart rate is extremely unstable; she could go into ventricular fibrillation and die at any second. We don’t have any more time to think."

Dean Song’s gaze fell on Yamada. "Professor Yamada, you have profound expertise in emergency medicine. In a situation like this, do you have any suggestions?"

Yamada felt everyone’s eyes on him, and his scalp began to prickle.

He steeled himself and stepped forward, picking up a stethoscope to listen to her heart sounds before looking over the horrifying test results again.

The heart sounds were distant and muffled, a classic sign of pericardial effusion and heart failure.

Her pulse was thready and weak—a clear sign of shock.

He lowered the stethoscope and remained silent for a long moment before finally shaking his head in defeat.

"I’m very sorry, Dean Song."

Yamada’s voice was low. "This is already the terminal stage of multi-organ failure. Whether we consider surgery or medication, the risks are immense. According to international protocols, the recommendation at this point would be to advise the family... on hospice care."

In other words, to cease treatment.