30 Reaching Perfection

"Hydrogen peroxide?" Lin Yuming asked, seizing the opportunity. "Director Guohua, I've never heard of hydrogen peroxide having any side effects."

"That’s because you aren't in clinical practice," Wang Guohua said in a low, serious voice. "Setting aside my own experience, the literature clearly states that it's not used abroad."

Lin Yuming stilled. If that were true, the incident involving hydrogen peroxide at the mining general hospital would definitely be considered a major medical malpractice case. How could that be?

"Director Guohua, could you elaborate?" Lin Yuming asked, his attitude shifting significantly from his previous dismissive demeanor.

"When I was young, we always used hydrogen peroxide or dilute iodine to irrigate. Dilute iodine causes intestinal adhesions and obstructions—the side effects are severe—so I preferred using hydrogen peroxide for disinfection. But in recent years, research has found that hydrogen peroxide can lead to air embolisms."

"In all these years, I've only encountered one case. Less than ten minutes after using hydrogen peroxide for disinfection, the ventilator started alarming. In the end, the patient never made it off the table."

"!!!"

"I later looked up the data and summarized my experience. I won't go into that, but when Luo Hao started using hydrogen peroxide during surgery, I began paying close attention. As it turns out, his process is completely compliant, minimizing the risks to the lowest possible level."

"Can we just not use it?" Lin Yuming asked.

"Not use it? A belly full of feces, postoperative bacteremia, severe intestinal adhesions, intestinal obstructions, and a minuscule chance of an air embolism—take your pick." Wang Guohua shut down Lin Yuming's suggestion immediately.

Lin Yuming scratched his head. He didn't want any of those options, if he could help it.

"There are many such small details. You wouldn't understand even if I told you."

"Director Guohua, could you be overthinking it? Luo Hao hasn't performed surgery for nearly two years; I saw that with my own eyes."

"Overthinking?" Wang Guohua’s eyes brimmed with disdain. "That's because you don't know enough. Let’s put it this way: throughout the entire surgery, I wanted to teach Luo Hao a thing or two, but damn it, I couldn't find a single wasted movement to correct."

"!!!" Lin Yuming was stunned.

"It gave me the impression that the person in the surgeon's position wasn't Luo Hao, but a professor from Peking Union Medical College Hospital. And not some cutting-edge young professor, but an old veteran who had been performing surgeries for a lifetime."

"Really?" Lin Yuming was both shocked and delighted.

"Of course. Why would I lie to you? Even if I were to lie, I wouldn't joke about surgery," Wang Guohua said.

Lin Yuming clicked his tongue.

"Your nephew is quite something. No wonder the First Affiliated Hospital of the Medical University wants to poach him for advanced studies and off-the-books work."

"Heh." Lin Yuming felt even happier than if someone had praised him directly.

"I'm heading home. Youren is hospitalized; call me if anything comes up." With that, Wang Guohua began changing his clothes, showing no intention of continuing the conversation with Lin Yuming.

...

Luo Hao stood at the head of the patient's bed for a full 20 minutes.

The task of treating the constipation was complete, and the diagnostic AI fragment had been obtained. However, while the system confirmed the surgery was a success, Luo Hao wasn't entirely certain. Even though the surgery had been performed without a single flaw, he kept his eyes fixed on the monitor for a long time.

"Luo Hao, do you have OCD? Have you seen anyone at a psychiatric hospital?" Chen Yong, who had come looking for Luo Hao twice, couldn't help but ask the second time.

"No, I just feel more at ease if I keep an eye on it for a while."

"If that isn't OCD, I don't know what is."

"You could interpret it as being diligent and responsible toward the patient."

"Cut the crap." Chen Yong pulled Luo Hao out. "It's late-night snack time. We can order milk tea; the nurses asked for it." As he spoke, Chen Yong handed Luo Hao a piece of paper with a few orders written on it.

"You're not short on money," Luo Hao glanced at Chen Yong and pulled out his phone to start placing the delivery order.

"I wouldn't dare treat the nurses to milk tea; things like this are safer when someone like you does it. You order the tea, and you’ll be called a 'warm man'."

"And what about you?" Luo Hao asked.

"I'm drinking iced Americano." Chen Yong ignored Luo Hao's question.

"Ordered." Luo Hao put his phone away. "Iced Americano in the middle of the night? Don't you want to sleep?"

"Why didn't you keep asking?" Chen Yong countered.

"Asking once is giving you face. If I keep asking and you say something unpleasant, wouldn't I be bringing it on myself?" Luo Hao smiled. "Actually, coffee and hospitals really go together."

"You mean besides drinking high-calorie milk tea for energy, we beasts of burden drink coffee to stay alert?"

"Every cause has an effect. Caffeine ground from coffee beans—the cycle of cause and effect. Just focus on healing the sick and saving lives; that’s your 'blessing'."

"Tsk tsk. Since Jack Ma, this is the first time I've heard someone describe the word 'blessing' so refreshingly."

The two talked as they returned to the doctor's office.

"Luo Hao, since you're so good at surgery, why on earth would you choose to go to the Medical Affairs Department?" Chen Yong looked casual, but he was actually asking his biggest question.

Luo Hao sat in his chair. "Chen Yong, what do you think is the most important thing for a doctor?"

"Of course, it's a benevolent heart and technical skill. Just these two things; everything else is just crooked ways," Chen Yong answered without hesitation.

"Those are very important, but there is one more thing that is equally vital."

"What?"

"Face."

"!!!" Chen Yong looked at Luo Hao with a complex expression, a mix of confusion and disdain in his eyes.

"People are not gods," Luo Hao explained with a faint smile. "My teacher told me that in a hospital, you cannot be arrogant about your talent. You should avoid offending people whenever possible."

"How are you so greasy at such a young age?"

"You call this greasy?" Luo Hao asked.

"Isn't it?"

"Let's assume a situation. For example, today's patient goes to the ICU post-surgery. If the ICU is full, what are you going to do?" Luo Hao asked.

"Uh..." Chen Yong didn't know how to answer this tricky question.

They were lucky today; the ICU happened to have an empty bed, and combined with a call from the Medical Affairs Department, the patient was moved directly to the ICU. But what if there were no beds? If they brought the patient back to the surgical ward, the nurses there weren't skilled enough. Once a ventilator was needed, not even the doctors, let alone the nurses, would know how to handle it.

"Whether the ICU had a bed or not today, I could have gotten the patient in. At worst, we'd add an extra bed. Would Director Qian of the ICU really pick a fight with my Medical Affairs Department over such a small matter?"

"..." Chen Yong was speechless.

"Don't say my example is special; there are even more extreme cases. If the ICU has no ventilators—if all the machines are in use—and our patient needs one, I ask you, what would you do?"

Chen Yong was expressionless, his mask seemingly frozen over with frost.

"You wouldn't have a way, but I could make one phone call, and Director Qian would be able to add a bed for me in the ICU."

"You wouldn't have a ventilator," Chen Yong reminded him, unconvinced.

Luo Hao smiled broadly. "There are 23 ventilators in the whole hospital. 16 are currently in operation, and 7 are idle. Ordinary doctors can't manage this, not even Wen Youren, but I can."

"Our hospital has 23 ventilators?!" Chen Yong was surprised.

"The Medical Affairs Department has the data. Director Lin requires a report on ventilator operation before he leaves work every day to stay informed. If a situation truly requires his intervention, as long as the patient needs a ventilator, it can be coordinated immediately."

"As for the costs, let the directors bicker about it afterward. At worst, my office will step in as the referee."

"Returning to the point, what I just described can ensure that at least 50 to 100 critically ill patients receive proper treatment every year. Of course, technical skill is also very important—I have never denied that—but what I said isn't 'greasy', is it?"

Chen Yong was somewhat dazed. He could understand what Luo Hao was saying, yet he couldn't quite grasp the implications.

...

"That is the power of the Medical Affairs Department, not 'face'," Chen Yong pointed out a flaw in Luo Hao's argument.

"Then let me give you another example. A patient with a difficult, mysterious illness comes to the hospital, and you can't figure it out. What do you do?"

"Ask my master," Chen Yong replied, steeling himself.

"Dr. Jiang's level is quite good, but what if he can't figure it out either?" Luo Hao asked.

"..."

"If it were me, I could get the directors of the relevant departments to sit down and study it together. If they still can't figure it out, in a few hours, the consultation will involve chief physicians from provincial hospitals. If they still can't diagnose it, I will contact my teachers, professors, and directors at Peking Union for a consultation."

"The Medical Affairs Department couldn't possibly do that, right?"

Chen Yong looked at Luo Hao's sunny, radiant smile and felt he was truly detestable! Like a contrarian, Chen Yong asked, "Peking Union isn't omnipotent. What if they can't figure it out either?"

"Oh, if my teacher can't understand it or provide an accurate diagnosis, he would surely be interested in the case. The next consultation team would be an MDT team composed of chairmen of various national professional committees."

*Damn!*

Chen Yong realized it now: Luo Hao was showing off without the slightest bit of concealment! This was pure, unadulterated showing off! Saying the most impressive things in the most casual tone. An MDT team composed of chairmen of various professional committees—is that the kind of setup for an ordinary person's medical care? That is the setup for high-level government healthcare.

"If there is still no confirmed diagnosis, then it's a pity—there's a 30% chance that the disease could be named after the patient."

Chen Yong sighed helplessly. With a different alma mater and a different learning process, Luo Hao had countless things to brag about. As for himself...

"By the way, that witchcraft you studied..."

"It's magic! Magic!"

"Yes, yes, magic. Can it treat illnesses?" Luo Hao asked with interest.

"Yes," Chen Yong said, feeling a bit dazed after being hit with a heavy blow by Luo Hao.

"Oh? Give me an example."

"Steve Jobs saw one of my teachers for his illness."

"You've got to be kidding! Steve Jobs was delayed by your teacher?!" Luo Hao was shocked.

Chen Yong was speechless. Foreigners believing in magic or witchcraft was essentially the same as people domestically believing in folk remedies. Steve Jobs was a classic example; his pancreatic cancer likely had a high probability of being cured, but it was delayed for so long that he passed away prematurely.

Luo Hao asked with interest what Chen Yong had studied in school, but Chen Yong started working with a blank expression, refusing Luo Hao's inquiry through action.

...

Wang Guohua tossed and turned, unable to sleep.

"You're at your age, and you're still going to the hospital for emergency surgery. Now you've got insomnia," Wang Guohua's wife nagged. She gave up on sleeping and went straight to the kitchen.

"What are you doing?" Wang Guohua asked.

"A friend got me some traditional Chinese medicine for calming the nerves. She said it's especially good. You wouldn't drink it when your brother gave it to you; if you had drunk it earlier, you wouldn't be having all this trouble."

"No!" Wang Guohua sat up abruptly.

"You're so difficult. I'm telling you, Old Wang, this medicine is really effective."

"You don't know a damn thing!" Wang Guohua cursed.

"Oh, you're the only one who knows everything! You think I enjoy getting up in the middle of the night to make medicine for you?" his wife complained.

"Come back here. Let me tell you something." Wang Guohua's tone softened slightly, and he pulled his wife to sit on the sofa. "Among the medicines for calming nerves, as long as they are 'effective', most contain lead acetate."

"What?"

"It's a traditional medicine, mentioned in the *Compendium of Materia Medica*. I heard Old Liu from the TCM department talk about it. The main component of lead acetate contains lead. 'Calm the nerves'? Calm your damn nerves! That's lead poisoning!"

Wang Guohua's wife froze.

"In the Qing Dynasty, princes were particularly fond of taking nerve-calming decoctions. They were truly effective! But statistics show the average age of those princes was 28. They died before they reached 30."

"Is it that scary?!" Wang Guohua's wife's face turned pale. "Old Wang, don't lie to me."

"Why would I lie to you?" Wang Guohua scolded. "Usually, I can't be bothered to talk about it, but I never expected you to actually go and get the medicine. We have the best doctor in the city in our own house, yet you don't believe in him and insist on trusting those side-door paths. Ridiculous! I don't know who spoiled you so much."

Although scolded, his wife didn't dare talk back, her face full of anxiety.

"Go to sleep. I ran into something today; I'll be fine once I get over it."

"Old Wang, do you think eating a little lead is okay?"

Wang Guohua's face darkened instantly. After ten minutes of fuss, Wang Guohua threw away all the medicine and sat on the sofa with a stern face. Seeing his dark expression, his wife didn't dare say another word and went to bed obediently. Even though her husband had judged that the dose she took wouldn't cause lead poisoning and said they would go to the hospital for tests the next day, she was still terrified. How could there be heavy metals in a nerve-calming decoction? Wang Guohua's wife couldn't sleep a wink either.

Wang Guohua looked at the pitch-black sky outside, thinking about that surgery. He had only told Lin Yuming three-tenths of the truth. The reason he was tossing and turning was that he realized there were details in Luo Hao's surgery that even he hadn't noticed in his haste. Simply put, Wang Guohua believed Luo Hao's surgery was better than his own!

Better than his own!

Not ERCP, not laparoscopic surgery, but a major, bold open surgery! Every time he thought of Luo Hao’s "ruthless" incision, Wang Guohua’s eyelids twitched. Although it was simple, direct, and brutal, it was the best way to solve the problem. In his youth, he had tried small incisions, but they had all failed, requiring multiple extensions during the surgery. After many surgeries, Wang Guohua summarized his experience: cut where you need to cut. That way, both the surgeon and the patient benefit.

But Luo Hao just went in and "blundered" through with a full, decisive cut right from the start. Wang Guohua felt like he had an idea, but he couldn't quite grasp it. The sky turned slightly pale. Wang Guohua dozed off for a bit, then changed his clothes to go to work.

...

Three days later.

In the past few days, Wang Guohua had admitted several related patients, waiting for the surgical day for treatment. Director Li of the Gastroenterology Department gave Wang Guohua the green light; after all, he was a senior predecessor in the hospital, and a basic level of respect was required. Even though Wang Guohua had a close relationship with Wen Youren, Director Li couldn't deny the old director this face.

When it was time to get off work, Luo Hao was organizing the various documents for the patients scheduled for surgery tomorrow one last time. These documents needed to be reported to the senior doctor; Luo Hao was well-versed in the routine.

"You can't have surgery tomorrow; you'll have to wait for the next surgical day. Get admitted first. There's no such thing as being admitted today and having surgery tomorrow." Wang Guohua's voice came from outside.

Luo Hao looked up and soon saw Wang Guohua walk in, followed by two people.

"Dr. Xiao Luo, this is my newly admitted patient," Wang Guohua said, pointing to the woman behind him. "Take the trouble to admit her."

Although he said "take the trouble," there was no hint of apology or guilt in his expression. It was the typical tone of a senior doctor delegating a task to Luo Hao. This was normal; what doctor gets off work on time? Other industries might be able to reorganize the workplace, leave on time, and refuse overtime, but doctors couldn't. As for the "trouble," it didn't exist in Wang Guohua's eyes; it was just something said perfunctorily.

"All right, Director Guohua," Luo Hao responded.

"Director Wang, please take a look at me and tell me what's wrong," the patient's family member pleaded in a low voice.

???

The patient hadn't spoken, but the family member was asking for a consultation? What was going on? Luo Hao looked at the man with curiosity.

"You're just idle and looking for trouble." Wang Guohua curled his lip, disdainful. "Those loafers and lazybones in the countryside, just like you, they all get dizzy the moment they start working."

Wang Guohua's voice was loud and full of vigor, like a thunderclap.

"..." The family member lowered his head sheepishly.

Luo Hao truly admired him; some things could only be said by an old director like Wang Guohua. If it were him, wouldn't he be complained about by patients until the end of time?

However...

The family member's face was full of defiance and confusion. Luo Hao's first instinct was—he wasn't faking it. There wasn't much useful information yet, and there was another patient admitted by Wang Guohua, so Luo Hao wasn't in a hurry. He greeted the patient and began taking the medical history.

After Wang Guohua admitted the patient, he didn't rush to change clothes and go home. Instead, he changed into casual clothes and sat in the doctor's office, wearing his reading glasses and reading a book. He kept his ears pricked, listening to the dialogue between Luo Hao and the patient.

Taking a medical history is a science. It looks simple, but even an old attending doctor struggles to be detailed and watertight. Wang Guohua looked up at Luo Hao from time to time. Luo Hao had a smile on his face, gentle and soft like a spring breeze. After asking for more than 20 minutes, he took the patient to the treatment room for a physical examination.

The intake process took an hour, and Wang Guohua couldn't find a single fault. Luo Hao was meticulous and comprehensive—it was perfect. As far as basic skills were concerned, he felt even he didn't have Luo Hao's level. Wang Guohua had an accurate judgment.

Luo Hao arranged a room for the patient and called the family member into the doctor's office to sign the papers. While recording the communication, Luo Hao asked, "When did the dizziness start when you work?"

"I forgot exactly when," the family member whispered while stealing a glance at Wang Guohua.

"What kind of discomfort do you feel when you work? Don't be nervous, just chat." Luo Hao smiled slightly and lowered his voice.

It was a bit strange for two grown men to whisper, but Luo Hao followed the family member's lead, engaging in a bit of self-deception so Wang Guohua wouldn't "know."

"As soon as I start working, within 5 minutes, I get dizzy and feel weak all over, especially in my arms; I can't exert any strength at all." As he spoke, the family member subconsciously moved his left arm.

"Hold out your hand and let me see."

The family member reached out his right hand.

"No, the left hand that's bothering you. Besides, men are on the left and women are on the right, you know."

???

The family member was full of question marks. Was this young doctor serious?

Luo Hao ignored the family member's feelings and placed his fingers on his radial artery. Wang Guohua looked up, his eyes widening in displeasure. This was nonsense! Why wasn't Luo Hao properly admitting the patient? Why was he chatting with that lazy family member and "examining" him? Besides, if he were doing a proper examination, he wouldn't say anything, but a Western medicine doctor actually taking the pulse of a patient's family member! Wang Guohua was very unhappy.

However, in the next second, Luo Hao ignored what he had just said about "men left, women right" and placed his hand on the patient's right radial artery.

"Have you been to the hospital to see a doctor?" Luo Hao asked.

"I have, but the doctor said there was nothing wrong with me," the family member said with distress. He had been ignored by many doctors, but now that a young doctor was examining him, he felt it was even more... unreliable, even somewhat comical. Because Luo Hao had his hands on both his wrists, like a child playing a game.

"Let's go, I'll take you to measure your blood pressure."

"Dr. Xiao Luo, hurry up and write the medical record." Wang Guohua was very unhappy. He slammed his copy of *History of Ming* shut and said in a muffled voice.

"Director Guohua, he might have a small problem," Luo Hao didn't listen to Wang Guohua, but answered seriously and firmly.

"Hmm?" Wang Guohua raised an eyebrow. He stood up, skeptical. "I'll go see what kind of problem he has."

If it were in the past, Wang Guohua would definitely have scoffed at Luo Hao's statement, thinking the young doctor was making trouble out of nothing. But after experiencing a few things, Wang Guohua's perception of Luo Hao had changed. This young man was bold yet meticulous, and his surgery was comparable to his own.

Wang Guohua even felt a certain degree of self-doubt. Could it be that this man wasn't the kind of lazybones from the countryside? In a flash, Wang Guohua smiled. Feeling weak all over the moment you start working, dizziness, a headache all over, a belly full of toothaches—isn't that the classic loafer? He had seen plenty of these people! He wanted to see what Luo Hao had to say.

Wang Guohua became interested and followed Luo Hao and the man to the nurse's station with his hands behind his back.

Luo Hao took out a mercury sphygmomanometer to measure the blood pressure.

Left upper limb blood pressure: 70/40 mmHg. Right upper limb blood pressure: 130/75 mmHg!

The pulse pressure difference reached 50 mmHg. Although Wang Guohua didn't have his stethoscope and his eyes were a bit blurry, he could still see the subtle fluctuations of the mercury from a distance and realized something was wrong immediately!

Could it be a dissection?!

The moment the thought occurred to him, Wang Guohua broke into a cold sweat. Dissection was a major illness! A pulse pressure difference of 50 mmHg between the two upper limbs—the possibility of a dissection was high!

"Have you ever been injured before?" Luo Hao asked calmly.

"Dr. Xiao Luo, the patient..." Wang Guohua said hurriedly.

But he only spoke a few words before swallowing the rest of his sentence. If Luo Hao could perceive the pulse pressure difference between the man's two upper limbs just by taking his pulse, how could he not know it was a dissection? He wasn't in a hurry; there must be a reason for his composure.