Path of Medicine With a System-Chapter 299: End of Zhang Fan’s rotations!

Leukemia was truly such a heart-rending disease. It was incredibly difficult to deal with. Out of all the malignant cancer types, leukemia ranked #6 in death rate in China. However, leukemia also ranked #1 in death rate as a cancer which killed children and adults younger than age 35!

That was the scariest part about leukemia. Young children who hadn’t even grown up to mature yet would be forced to bear such tremendous pain so early in their life. The hematology department at larger hospitals would always be filled with bald young children. This was something truly heartbreaking and painful to behold.

What exactly was leukemia? To explain it rather simply, when leukemia was first discovered, it mostly afflicted people who worked with or had come into contact with radiation before. Leukemia had been particularly common in Japan after World War 2. Japan’s leukemia research was at the top of the world because Japan had a large number of leukemia patients after World War 2 due to the nuclear bombs.

After that, the next most common type of leukemia patient would be workers who had come into contact with various chemicals for a prolonged period of time. For instance, people who worked in shoe factories back in the early days. Making shoes required a certain chemical which contained benzene. Leukemia would also occur in construction company employees.

There were also some special viruses which could cause leukemia. However, these specific viruses were unknown!

The last type of leukemia was inherited. These were all possible causes of leukemia.

Normal people would be unable to avoid viruses and genetic problems. It wasn’t possible for one to choose their own genes. However, at least it would be possible to avoid radiation and chemical substances.

For instance, when it came to home renovation, no matter what style or materials you used, it wouldn’t be of any use at all. Chinese construction companies would use countless chemical glues and radioactive materials even though it was illegal. Would a layman possibly understand what was harmful or not? Of course not! In that case, the only answer was to renovate as simply as possible! Even now, leukemia’s exact causes were unknown! Just which specific chemical would cause it? Sorry, that was unknown!

Chemicals and radioactive substances were both capable of stimulating the human body. Children’s bodies would be especially sensitive to such stimulation. It would cause a change in the genes inside the body which would then lead to leukemia.

Many people would think that leukemia was a type of white blood cell disease[1]. This would actually be a mistake. To explain simply, leukemia would be caused by a sudden change in one’s genes, leading to hemopoietic malignant clones.

Hemopoietic cells were basically the precursor to red blood cells, white blood cells, and blood platelets in the blood vessels. Various factors would transform the hemopoietic cells into the other three types of cells. Leukemia would occur because of genetic factors causing large amounts of malignant cloning of the hemopoietic cells, meaning that the hemopoietic cells would excessively clone without maturing. These hemopoietic cells not maturing meant that they would be useless. This large number of useless cells would take up living space meant for normal cells. Leukemia was actually a disease which would lower the number of all three main blood cell types.

Why was leukemia so disgusting to deal with? First of all, it loved to bully children who were still young and weak. Secondly, it was a blood disease, which meant that it would affect the entire body. Leukemia was also highly difficult to detect in its early stages because it was located in the bone marrow and its symptoms weren’t obvious. There was only one early symptom: chest pain! Some leukemia patients might not even experience this one symptom!

The bone marrow was an organ for creating blood. The breastbone contained the bone marrow closest to the surface of the human body, which was why it would start feeling painful first. But, was it really possible to detect early leukemia? It would be almost impossible. By the time that the pain was noticeable enough, the leukemia would have already developed in the entire body, and even though the disease was in the bone marrow, the symptoms would be displayed elsewhere. There were many different types of leukemia which would have various different symptoms. For instance, gum bleeding, lymph node swelling, migraine, skin disease, or even testicle pain in men. It was possible for symptoms to appear anywhere in the body.

This was also why leukemia absolutely required chemotherapy to treat. Chemotherapy would actually be a process of using various medications to kill all the cancerous cells which were spread throughout the entire body. The medicine wouldn’t be able to differentiate between good cells and bad cells. It would kill both normal and abnormal cells, at most being slightly selective.

Thanks to technological advancements, Novartis, an incredibly powerful pharmaceutical company, managed to create imatinib, a molecular targeted drug. What exactly were molecular targeted drugs? Such a drug would be capable of directly affecting the abnormal genes so that the cancerous cells would no longer be produced. This was a foundational cure.

Although this imatinib drug was truly amazing, it was also tremendously expensive. One year’s supply of European-produced imatinib for a patient would cost 300,000 yuan at minimum. That was only the cost for this one medication alone, not counting all other medical treatment fees and medicine costs. Since Novartis was really powerful, it had the ability to set its own prices. What did that mean? Novartis could sell its drugs for whatever prices it wanted in different countries. If people didn’t want to purchase its drugs at those prices, then Novartis simply wouldn’t sell anything at all!

Although Chinese pharmaceutical companies were also capable of producing imatinib, this drug was something really high-level. The Chinese generic version’s effectiveness was far less than Novartis’s imatinib.

“Doctor Zhang, please start on the paperwork for Little Yu so that he can receive a blood test examination,” Doctor Ruan told Zhang Fan.

“Sure thing. Here, young man, I’ll get the paperwork started for you.”

As Zhang Fan worked on the necessary paperwork, he asked Jiang Chunyu, “Could I ask you to talk about your leukemia treatment?”

Zhang Fan had been in the hematology department for over a week now, but he had yet to meet a leukemia patient. Now that he met a leukemia patient whose treatment was fairly successful, Zhang Fan was really curious out of a desire to learn more medical knowledge.

“Alright. I don’t know what I should say, so I suppose I should start from the beginning,” Jiang Chunyu answered after some slight hesitation. He had never talked about his leukemia treatment with anyone before over the past few years.

Zhang Fan had Jiang Chunyu sit down as the latter recalled his memories.

“Back when I was diagnosed with leukemia for certain, I truly couldn’t even imagine that I had leukemia. I didn’t believe it at all. Why would I get leukemia? Could the doctor have made a misdiagnosis? However, the examination results and my symptoms all matched leukemia! It was the strain known as acute myelogenous leukemia! After I was hospitalized, I kept having endless amounts of blood being drawn from me. I then began chemotherapy.”

Jiang Chunyu then paused for a moment, and smiled shyly before continuing, “I used to have long hair, in a hairstyle similar to Liu Dehua’s (a famous Chinese singer). Haha, my hair was really beautiful, but I was forced to change my hairstyle after chemotherapy. I then felt all sorts of discomfort and disgust. I vomited everything that I ate. I had no appetite at all. It was as if there was a layer of plastic in my stomach that made me constantly vomit!

“The hematology department had a lot more patients back then. There were so many people with all sorts of blood diseases here. We would encourage and support each other. Although many of the people from that time passed away, those days truly helped me to feel so much warmth. They also helped me to really mature.

“During the most painful period of my chemotherapy, I would look at my parents who were sleeping on cots in my patient room every night. Honestly, sometimes, when I looked at the window, I truly wanted to jump out and end everything. Why suffer through so much pain? I was in pain, my parents were in pain, and I have an older brother as well as younger brother. It wouldn’t make much of a difference if I wasn’t around.”

Zhang Fan looked strangely at this young man who still had a shy smile when he heard this. Although Jiang Chunyu seemed to be rather shy, his words contained endless suffering and experience!

Jiang Chunyu noticed Zhang Fan’s strange look, but continued to smile, and said, “Maybe my parents also noticed how I was back then, which was why they kept such a close eye on me. They kept encouraging me so much. My mom would always say, ‘Little Yu, just look at how much we’re suffering here. You need to do your best. You have to be filial to us when we’re old.’ At that time, I was still young and didn’t understand them. Plus, the chemotherapy was really painful, so I would always get really angry.

“My father also had a bad temper, but that year, his personality really changed. He became incredibly gentle. Even his words would be soft and slow. My older brother also donated bone marrow for my sake. Maybe the heavens felt that they were being too cruel to me as my chemotherapy results kept becoming better and better.

“I was finally discharged from the hospital in the end. Just look, I’m just like any other regular person now. My greatest wish now is to stay here after I graduate from college and be as filial to my parents as I can.” Jiang Chunyu smiled beautifully after saying this!

“You being able to healthily grow up is already the best way of being filial to your parents. Face whatever’s in the future with courage. Don’t think about anything else,” Zhang Fan told Jiang Chunyu while handing the latter the paperwork needed to get a blood test.

“Yeah. I’m mature now. I won’t make my parents sad. Thank you, Doctor Zhang. I’m leaving now for my blood test.”

“Okay! You should go now.” Zhang Fan felt like his heart was really warm after hearing this story. He hoped that there would be no illness at all in the world! He hoped that youngsters like Jiang Chunyu could remain far away from demons like cancer!

One month passed by quite swiftly. Zhang Fan finished his rotation in the hematology department. This was his last time as a rotation doctor. Although Zhang Fan still had many regrets about not being able to do more rotations, this past year of rotations had truly helped him gain so much medical knowledge.

Over the past year, Zhang Fan had seen various departments, diseases, and patients. There were patients who were cured, those who weren’t, and also those who had died. These patients had helped to give Zhang Fan his own medical treatment philosophy. Although he had his System, the System was only a practice tool. Besides, a doctor would treat actual people, not mass-produced cars or furniture. Only treating actual people would help a new doctor to improve the most.

No matter how skilled a doctor became in the future, their actual medical professionalism would be established in their first few years as a doctor. These new doctors who had just joined the field would be the most shocked and touched when they first faced life and death. As time passed by and the new doctors matured, their hearts would end up hardening to become like stone. This was the helplessness in being a Chinese doctor.

Many excellent doctors would see far too much death over their medical career. No matter how shocking a patient’s situation was, it would never be as shocking as the doctor’s first contact with death. This was something irreplaceable. That was why the first few years would be so important to any doctor.

These first few years would also be the most difficult for these doctors. They wouldn’t have much income. They would barely even have any so-called human rights. Yet, they would have to try and get married, have children, and get permanently assigned to a department. These were all really important. At any hospital, the new doctors would always have the most work and heaviest workload. Not only that, the patients wouldn’t trust them. “He’s still so young! What would he even know? Get me a different doctor!” Yes, you could choose your own doctor, but sometimes, please consider things and give them a little, just a little bit of face! Being more polite and respectful wouldn’t cost you anything!

The intern doctors wouldn’t be afraid of working hard. Sometimes, they would have to work for more than 20, or even 30 hours in a row. All rotation doctors would have to go through this. They didn’t mind this, as they had chosen the doctor profession for themselves. However, the heart would forever hurt more than any fatigue. If you didn’t give any face at all to the new doctors, did you ever consider that their way of thinking might become distorted in the future?

Zhang Fan and the doctors from his year all finished their rotations together. Although there were some doctors who had managed to get permanently assigned to a department earlier than this, the remaining doctors who went through the proper process only finished now. Were they all happy? Yes, they were happy. Of course, there were also some who weren’t happy. That would be those who hadn’t done well on their medical license exam and those who hadn’t performed well during rotation, meaning that they didn’t get assigned to a department that they liked. Well, it was too late now!

These young doctors were no longer immature after the trials of being a rotation doctor. They were now proper doctors. For once, Superintendent Ouyang was generous and treated them all to a big meal. This was the first batch of doctors who had been raised according to her rotation doctor method. She would of course value these doctors more since they would have better foundational knowledge. Sometimes, being a doctor wouldn’t require you to have very deep knowledge, but your knowledge would have to be encompassing and general.

Superintendent Ouyang paid for a big meal at J Hotel, which was a relatively nice hotel in Chasu City. Of course, Superintendent Ouyang wasn’t willing to spend money at the highest-class hotel in Chasu City. Still, she paid for reservations for three large tables which would seat more than 20 people each. These three tables were completely filled.

Apart from a few of the hospital leaders, everyone else present at this meal was a rotation doctor. For once, Superintendent Ouyang toasted everyone with a glass of white wine. She almost never drank alcohol. Even if she had to eat a meal with a government leader who came to check on things at the hospital, Superintendent Ouyang still wouldn’t drink alcohol. She was powerful enough not to have to drink alcohol.

But today, she was wearing celebratory attire, and didn’t have her typical frosty expression. She had a happy expression as she raised her glass, and said, “All of you are the youngest generation at our hospital. You’ve now made it past the rotation doctor stage. You’ve experienced bitterness, sadness, happiness, helplessness, and fatigue. But now, all of you are the best. All of you have made it past this stage. Although your lives as doctors are just beginning, this experience of being a rotation doctor will become the foundation for your future medical path. I believe that nothing will be too difficult for you in the future, because you’ve already made it past this most difficult stage. Why would you be afraid of anything else? Today, I represent the hospital in welcoming you all in formally becoming doctors and members of the hospital. Come, raise your glasses and drink your wine! Enjoy this meal! I hope that all of you will become even more amazing at your future positions. Please don’t forget, pleases don’t abandon the spirit and good habits that you cultivated as a rotation doctor! Come! Toast!”

The young doctors all heaved sighs of relief on this night. No matter if they were in a good department or not, they had finally been permanently assigned to respective departments. They would no longer be like homeless dogs that didn’t even have a feeling of belonging anywhere.

Superintendent Ouyang secretly left after just three glasses of wine. She knew that the young doctors would never be able to truly relax with her around. Since Superintendent Ouyang had left, the other vice superintendents of the hospital left as well. The only hospital leader remaining at the meal was the hospital secretary of Chasu City Hospital, who was forever the most powerless leader!

Zhang Fan didn’t drink a single drop of alcohol in response to Superintendent Ouyang’s toast of three glasses. There was no helping it. Zhang Fan knew that he would likely fall unconscious before Superintendent Ouyang even left if he had. That was why he didn’t drink at all.

After Superintendent Ouyang left, the young doctors finally started releasing all their stress from this hard time of being a rotation doctor. They started singing and dancing. There was even one male doctor who absolutely insisted on dancing with the hospital secretary, who was an old man! The hospital secretary could only smile and accompany them in their passion. Were the doctors really going wild? Yes, they were, but they had the right to! After making it past the rotation doctor stage, they would formally become doctors! Everyone would respect their hard work!

This night of partying washed away all darkness in their hearts. Although they were now merely resident doctor slaves instead of rotation doctor slaves, at least they had a home now.

This was the end of rotations for them all!

[1] TL/N: in Chinese, leukemia is literally spelled as “white blood” disease