32 The Big Pit

"Hello, Professor Zhou," Wen Youren said politely.

"Little Wen? What's the matter, calling me so late?"

"Professor Zhou... I've been thinking about introducing some interventional procedures here lately. I'm not very well-prepared and I'm feeling a bit uncertain, so I wanted to ask for your advice."

"What did you say? Interventional procedures?!"

The voice on the other end of the line suddenly spiked, becoming sharp and stinging Wen Youren's eardrum.

What was going on?

Wen Youren had just been making things up, never expecting to step on Professor Zhou’s tail. The man on the other end of the phone practically jumped out of his skin. Wen Youren even felt that the usually mild-mannered Professor Zhou might crawl through the phone line in the next second to deliver a sound slap to his face.

What had happened?

"Professor Zhou, I... I..." Wen Youren, failing to gauge the other man's attitude, didn't dare speak freely.

"Why would you be willing to dabble in such crooked, unorthodox methods!" Professor Zhou roared.

"..."

Wen Youren felt a deep sense of agreement with what the professor said. As the other man angrily cursed, Wen Youren felt as if he had met a kindred spirit, listening with glee. It was as if Professor Zhou were scolding Luo Hao, cursing him on his behalf.

Crooked, unorthodox methods—yes, that was exactly what they were!

"Professor Zhou, please, calm down. Don't ruin your health over this," Wen Youren said hurriedly once the other man paused to catch his breath. "I’m being forced into this, I have no choice."

And so, Wen Youren began to recount recent events at the Mining General Hospital. He embellished the story—the oil was peanut oil and the vinegar was aged, and he told the whole tale with great indignation. The account of his being suppressed and slandered was enough to move listeners to tears—especially the part about Luo Hao standing on stage, using a microphone to mock his lack of skill in both diagnosis and fighting, and finally being put down by Lin Yuming, who told him that even with an opportunity, he was still useless.

As Wen Youren spoke, a sense of sorrow welled up, and he nearly burst into tears.

"Oh, if it's just puncture procedures and ERCP, that's not a big deal," Professor Zhou said, completely unconcerned about Wen Youren's plight. Hearing that it wasn't about treating liver cancer, he reverted to his usual detached demeanor.

"Professor Zhou, they’ve gone too far. I suspect they’ll soon be reaching into the realm of liver cancer treatment."

Wen Youren wasn't stupid; he had gauged the man's weak spot during the conversation and began to provoke him.

"Hmph! A bunch of dogs! Interventional treatment for liver cancer? Using a high-pressure injector to force drugs and contrast agents in, spreading cancer cells all over the body—I really don't know what they're thinking! Is that treating a disease? That's murder!"

"Professor Zhou, could you explain that in detail? I don't know much about interventional surgery; I'm just desperate to make some changes," Wen Youren asked.

Among the completed medical records and patients, Wen Youren really couldn't find any flaws in Luo Hao's work, so he had a sudden inspiration to consult this bigwig of hepatobiliary surgery in the provincial capital.

"In liver cancer treatment, early and mid-stage cases are primarily treated with surgery, and late-stage with radiotherapy and chemotherapy. Those interventional people insist on turning this into their own surgical domain. It’s nonsense."

Wen Youren listened quietly. But no matter how the professor spoke, he kept circling back to the idea that interventional doctors shouldn't overreach their bounds into the treatment scope of the hepatobiliary department.

This was an academic dispute in the medical field, not what Wen Youren wanted to hear. Such matters were always a case of "to each their own," where one's position determined one's perspective, and it all boiled down to which big shot held more status in the professional hierarchy. For instance, ten years ago, when interventional procedures were already in full swing, the "Liver Cancer Treatment Guidelines" didn't even mention the word "interventional." It had only been included in the guidelines in recent years. There was no other reason; it was simply because the big shots of hepatobiliary surgery held more power.

Waiting for the other man to calm down slightly, Wen Youren guided him: "Professor Zhou, I also think this type of procedure and technique is bad. Are there any other problems with them? Could you elaborate?"

"There are plenty of problems." A scornful snort came from the other side. "Let's not even talk about anything else. Look at the lipiodol they use for liver cancer treatment. Go find the instruction manual and see what's written on it."

"Ah?!" Wen Youren gasped subconsciously. He felt as if he had discovered a new continent, his heart pounding wildly.

"The lipiodol manual clearly states: 'Positive contrast agent for X-ray diagnosis. Used for bronchography, hysterosalpingography, and for imaging of sinuses, parotid ducts, and other cavities and fistulas.'"

"No mention of liver cancer treatment?!" Wen Youren was surprised.

"Of course not," Professor Zhou replied. "They are using drugs off-label. Where does that put the safety of the patients? When I say interventional surgery is an unorthodox, crooked method, I’m not just talking empty words."

"Does the drug regulatory bureau not care?" Wen Youren's heart raced, his mouth dry as he swallowed hard, though there was no moisture to be found.

"They do care," Professor Zhou said dismissively. "Before, because the manual didn't list relevant treatment scopes, imports were stopped for a while. And guess what happened?"

"What happened, Professor Zhou?"

"That bunch of idiots started scouting for lipiodol everywhere in the country, insisting on continuing their surgeries. You tell me, what kind of nonsense is that!"

"In the end, that French company raised the price on the spot. The drug, which cost two or three hundred per ampoule, jumped by a thousand yuan."

Price hikes and the indications in the manual were two different things, but at this moment, Professor Zhou mixed them together. It seemed he had long harbored a grudge against the interventional department and was now beyond caring what he said.

"Professor Zhou, looking at it this way, the interventional department really shouldn't be performing these surgeries," Wen Youren echoed.

"It's the interventional treatment of liver cancer!" Professor Zhou emphasized.

"Yes, yes, exactly."

"Lipiodol must not enter the bloodstream. The manual states it in black and white. This bunch of dogs has been using it off-label for years! They really are a piece of work."

Wen Youren braced himself to listen to Professor Zhou curse for a while longer. Finally, after the professor warned him strictly not to perform interventional treatment for liver cancer, he hung up the phone.

The call had yielded results.

However, Luo Hao hadn't performed any interventional liver cancer surgeries, and Lin Yuming was watching. Wen Youren began to carefully calculate the situation in his heart, and gradually, a plan emerged.

If Luo Hao didn't do it, he could goad him into doing it.

As long as he performed interventional liver cancer surgery, he would inevitably have to use lipiodol. Some things might seem light, but once they hit the scale, they could be impossible to bear. Lipiodol shouldn't enter the bloodstream—he would find the manual and confirm it. If that were the case... heh heh.

He would lower his stance, and let Luo Hao perform the surgery together with his mentor—the one who had stabbed him in the back.

And then!

Wen Youren didn't realize that by the time he thought this, a genuine smile had already appeared on the corners of his lips.

That was it!

If you dare to plot against me, then just wait and see!!

...

...

Luo Hao was unaware of what had happened on Wen Youren's side. He went to work as usual, seeing patients and performing surgeries. The system task was a matter of slow, patient grinding.

Early in the morning, Luo Hao arrived at the hospital. Wen Youren, wearing a clean white coat with noticeable creases, stood in the corridor talking to Wang Guohua. Seeing Luo Hao arrive, Wen Youren waved enthusiastically, as if they were old friends.

"Little Luo, come here for a second."

Oh?

Luo Hao felt something wasn't quite right. Although his mental power had only increased by 1 point, he could feel a massive change. His sixth sense had now been developed. It might only be a guess, but when Luo Hao saw Wen Youren’s beaming, amiable face, he immediately became guarded.

"Director Wen, good morning," Luo Hao said with a smile.

"I was just about to tell Master," Wen Youren said. "A patient came to me, needing liver cancer surgery."

"Oh." Luo Hao remained calm.

Giving the surgery to him? Luo Hao didn't think that was possible. Currently, his relationship with Wen Youren was, if not exactly fire and water, certainly not good.

"You know how to do interventional surgery, right? Help me with an angiogram before the operation, and do a simple embolization with lipiodol," Wen Youren said.

Luo Hao was puzzled. What was wrong with Wen Youren today?

"A friend brought back a treatment plan from Shanghai, but they couldn't get admitted there. I wonder if you can do it, Little Luo?" Wen Youren pushed the question onto a "friend."

"I'll look into this," Wang Guohua said without suspicion, his voice gruff. "A few years ago, a patient went to the Eastern Hepatobiliary Surgery Hospital for surgery. I helped make the connection, and indeed, they said the interventional department had to be involved before and after the surgery."

"Exactly, Master," Wen Youren said with a chuckle. "The addition of interventional surgery can significantly improve the success rate of liver cancer treatment. No one did it before, and my surgical volume here is too high; I never had time to learn. Now it's great—a little 'Luo' has dropped from the sky."

Luo Hao’s smile remained unchanged, but in his heart, he became increasingly certain that something was wrong with Wen Youren. His sixth sense was quite interesting; no wonder people always talked about women's intuition. Looking at Wen Youren’s smile, Luo Hao’s mind had already flown to the other side of the sky. But he still didn't know what Wen Youren was plotting.

"Little Luo, you and Little Chen take the patient in," Wang Guohua said with a wave of his hand, leaving no room for doubt.

"You got it."

After admitting the patient, Luo Hao inquired about the medical history and thought for a long time, but still couldn't figure out what medicine Wen Youren was selling in his gourd.

It was strange.

Had Wen Youren really turned over a new leaf? Or was it that, for the sake of Wang Guohua's face, he genuinely wanted to introduce new technology to better treat diseases, and thus was willing to integrate interventional surgery?

Since he couldn't figure it out, he would stop thinking about it for now. Luo Hao was naturally broad-minded and set the matter aside.

"Luo Hao, don't you feel like something's not right?" Chen Yong asked after finishing the medical record.

"What's wrong?"

"Let's go, let's go have a smoke."

The two went to the fire escape, but Chen Yong didn't take out a cigarette. Instead, he lowered his voice and asked, "Director Wen admitting a patient and even proactively wanting to do interventional surgery—that doesn't fit his personality."

"Ha." Luo Hao laughed. "What is Director Wen's personality?"

"Be serious, I always feel like there's a huge pit in this," Chen Yong said gravely. "The few deputy directors previously in the department were all squeezed out by him using various methods."

"For example?" Luo Hao didn't know the old stories of the general surgery department, so he asked.

"I don't know the specifics, you can ask my master. Oh right, my master's copyright fee came in, and he asked me to ask you when you'd be free to have a meal together."

"Noon?"

"Sure."

Jiang Wenming hadn't called Luo Hao himself, so by standard metrics, the invitation didn't seem entirely sincere. But Luo Hao didn't care; he was very interested in Jiang Wenming. During that surgery, Jiang Wenming hadn't just been concerned with treating the illness but had also considered the future of the two people who had acted on impulse. Although the patient's condition was very serious and his goal hadn't been met, it had still earned him enough favor in Luo Hao's eyes.

After agreeing to meet at Feiyang Barbecue at noon, Luo Hao went back to work.

At noon, Luo Hao arrived at Feiyang Barbecue as promised. Boss Ding had already saved the only private room. After the three sat down, Luo Hao asked curiously, "Teacher Jiang..."

"Don't call me teacher, call me brother," Jiang Wenming waved his hand.

"Brother Jiang, I heard you wrote 'Surrounded by Beauties,' is that true?"

"Yeah," Jiang Wenming nodded. His expression was flat, without a hint of pride, as if he were talking about someone else's affairs.

"That name... it's really something," Luo Hao didn't know what to say.

"Hahaha," Jiang Wenming laughed. "Do you think it's vulgar to the core?"

"Yeah." Luo Hao didn't spare Jiang Wenming's feelings and gave a direct, affirmative answer.

"There are so many books and so many games. If you pick a literary name, who would click on it? Great vulgarity is great refinement. Look at the readers and players—when they see 'Surrounded by Beauties,' don't they want to click in and take a look?"

"Yes." Luo Hao answered honestly. "What kind of beauties are there, Brother Jiang?"

"All kinds. If you can imagine it, the company can make it. I wrote fewer types, but recently the game company asked me to add some more."

"Oh?"

"Let's put it this way," Jiang Wenming said casually. "When the economy was good in neighboring Japan, the 'mature sister' type was all the rage. We're about the same. There was a book called 'I Really Am a Big Star,' and the author loved mature sisters."

Luo Hao had heard of this book but hadn't read it. The name was indeed simple and direct, similar to what Jiang Wenming described.

"When the economy gets a bit worse, the style starts to get chaotic. When the economy is in a continuous downturn, the 'childhood sweetheart' style dominates the market—starting with a childhood sweetheart falling from the sky, and the protagonist just needs to be responsible for making money. Later on, as the economy gets more and more severe, the protagonists in the books just pick up 'pure maidens' who are 'hundred-man slayers.'"

"Uh~ ha~" Luo Hao didn't understand how "pure," "hundred-man slayer," and "female bodhisattva" could be mixed together, and emitted two strange sounds.

"I was just trying it out, didn't expect it to actually work," Jiang Wenming said with a smile. "Now I can rest easy in the clinic. Oh right, Director Wen had a talk with me a few days ago."

Jiang Wenming seemed unwilling to talk about his own affairs, and after chatting for a few sentences, he steered the topic back to the hospital. This was his purpose for seeking him out. Luo Hao sat up straight and listened carefully.

"Director Wen told me I must admit five liver cancer patients every month, or he'll deduct my bonus."

"Brother Jiang, you don't care about that bit of money anymore, do you?" Luo Hao asked.

"It's not about the money, but this matter is interesting. Add that to what Little Chen said about Director Wen's change—don't you feel like something's not right?"

Jiang Wenming's thoughts matched Luo Hao's.

Luo Hao replied seriously, "I do feel like something is wrong, but I haven't figured it out."

"Neither have I," Jiang Wenming warned. "But you should be careful in general surgery. Director Wen doing this, and doing it so enthusiastically, must have a deep underlying meaning."

Luo Hao smiled.

"Oh right, Brother Jiang, I heard that the general surgery department used to have deputy directors with strong technical skills. Why did they all leave later?"

"I was just a junior doctor when I first arrived. Director Wen had just become director. His first step was to send a socially awkward attending physician to the emergency department. The emergency department was short-handed, and the hospital asked general surgery to send someone to support them, and that's what Director Wen did."

"It seemed fine, but support for the emergency department usually lasts half a year, with a few people taking turns. After Old Hua was sent there, he stayed in the emergency department, responsible for 120 calls."

Luo Hao nodded.

"Later on, anyone whose surgical skills were better than Director Wen's was squeezed out, for various reasons. There was even a deputy director back then who did his job without any flaws, and Director Wen directly suspended his surgeries."

"Did the hospital not care?" Luo Hao asked.

"Internal department issues—as long as there's no medical malpractice, the hospital has no reason to intervene. Director Wen could also tell the hospital leadership that his subordinates were all troublemakers, but do you think the leadership didn't know the truth?"

"If he could rise to that position, he naturally had the support of the hospital leadership. Factionalism is inevitable."

Jiang Wenming calmly recounted what had happened in general surgery over the past decade. He didn't curse Wen Youren once, but every sentence seemed to be doing exactly that.

"Brother Jiang, you were driven away because of these things too, right?" Luo Hao laughed.

"Who says that? I applied for it myself," Jiang Wenming said. "The original work for the hit game is as awesome as it gets. Now I have many manufacturers looking for custom work; any one of them is a big deal. There's no need to be a nuisance in the department."

"Are you planning to resign?" Luo Hao asked.

Jiang Wenming shook his head. "I'm not good at socializing, why would I resign? I've been a doctor for half my life; even with some money, I shouldn't get carried away. It's more reassuring to stay in the hospital. Let me tell you, Little Luo, we doctors might not seem to have a high upper limit, but our lower limit is truly very high."

Luo Hao nodded repeatedly.

"I'm telling you to be careful. Chen Yong has done a few ERCP cases recently. What do you think of his skills?"

Jiang Wenming changed the topic extremely quickly, somewhat abruptly.

"His level is quite high."

"That's what I think too. When you have time, give Chen Yong more surgeries." Jiang Wenming used the word "give," already treating Luo Hao as a superior doctor.

"Brother Jiang, you're too polite. I'm also just a junior doctor."

"A junior doctor, huh?" Jiang Wenming's expression was quite intriguing.

"Certainly..."

As they were talking, Boss Ding lifted the curtain to serve the dishes.

"Luo Hao!"

Zhou Tianci happened to pass by. Seeing Luo Hao, he paused slightly, then immediately walked in with a big smile.

"Tianci, why are you here?" Luo Hao asked.

"I'm bringing... someone here for a cardiac ultrasound." Seeing there was a stranger, Zhou Tianci didn't speak too clearly.

"Everything good?"

"Good," Zhou Tianci said, beaming. "I used to think a ventricular septal defect was such a big problem. If it needed surgery, you'd have to use a sternal saw to open the chest, do the surgery, and then sew it up." He gestured across his chest as he spoke. "In the end, the surgery took less than an hour, and there were no issues post-op; it was like the surgery never happened. The follow-up exam showed the defect was gone."

"As long as the surgery was successful," Luo Hao smiled.

"Then I won't disturb you." Zhou Tianci only said a few words and, not daring to bother Luo Hao, took his leave.

Luo Hao didn't try to keep him. He closed the door and continued eating and chatting with Jiang Wenming and Chen Yong.

"Do you have any surgeries this weekend?" Jiang Wenming asked.

"No, I have to go to the provincial capital this weekend."

"Oh? What for?"

"My car needs maintenance."

Jiang Wenming was stunned for a moment, looking Luo Hao up and down, as if he had heard something extremely laughable.

"Luo Hao, your piece-of-junk car needs to go to the provincial capital for maintenance?" Chen Yong was straightforward and asked what Jiang Wenming found funny.

"Because it's such a piece of junk, there's nowhere in Donglian City to fix it," Luo Hao said calmly.

Jiang Wenming steered the conversation to lighter topics. He wasn't old, but he was very knowledgeable, and many things he mentioned were things Luo Hao had never even heard of. The meal was pleasant, and Luo Hao's favor for Jiang Wenming increased further.

After the meal, Jiang Wenming tried to pay, but Boss Ding said someone had already paid the bill.

"Little Luo, it's really hard to treat you to a meal." Jiang Wenming was helpless. "This one counts as your treat. Let's get together again next week, it's settled that I'll pay then."

Luo Hao exchanged a few polite words with Jiang Wenming and, seeing Zhou Tianci at the entrance of Feiyang Barbecue, excused himself to go find him.

"Tianci, you're being too polite," Luo Hao laughed.

"It's only right. You don't know how grateful Section Chief Duan is to you," Zhou Tianci whispered in Luo Hao's ear. "Are you free this weekend?"

"Hmm? What's the matter?"

"Section Chief Duan saw that your car was too junky and mentioned it to me two or three times. Since I'm going to the provincial capital this weekend, someone from the capital has organized a gathering."

Zhou Tianci spoke mysteriously, as if there were something illicit about it.

"Oh? What kind of gathering? Ha, never mind, I won't ask," Luo Hao smiled.

"We're all our own people, there's nothing I can't say," Zhou Tianci said. "We're importing coal from Mongolia. Our mining area has the follow-up equipment, and we can just handle the transaction."

Luo Hao wasn't interested in such things, letting it go in one ear and out the other.

"Section Chief Duan has been thinking about how to express his gratitude. This time, two coal bosses from Inner Mongolia are hosting, and one of them owns a 4S dealership in the provincial capital."

"I can get a discount on a car," Luo Hao laughed.

"We aren't taking it for free, just a discount. Whether the business succeeds or not has nothing to do with buying a car. You can rest assured."

"Forget it, forget it. I accept the gratitude, but I'll pass on the car."

"Why are you so polite! Are you busy this weekend or not?" Zhou Tianci was a bit unhappy.

"I'm driving to the provincial capital this weekend anyway."

"That's just perfect, it's on the way," Zhou Tianci said. "It's settled then. You just go take a look; if there's nothing suitable, then we'll talk."

...

...

Note 1: Many general surgeons have similar thoughts; it's very frustrating.

Note 2: This is a controversial case. In the 1960s, a Japanese doctor performed the first interventional treatment for liver cancer; in the 1980s, lipiodol began to be used for interventional embolization. At that time, the lipiodol manual did not include such applications. Because of conflicts with the drug regulatory bureau, lipiodol produced by the French company Guerbet could not be imported around 2009. The story of Professor Xu Ke from the Traditional Chinese Medicine University borrowing lipiodol nationwide to perform surgeries is true. It wasn't until around 2013 that the scope of application for liver cancer interventional treatment was added to the lipiodol manual, avoiding the embarrassment of off-label use. This plot is based on real events with some dramatization; after all, it happened a long time ago, the people involved are big shots, and the details are speculative.