9. Hungry Bones
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[Main Quest: Less Damage, More Possibilities — Phase One
Quest Objective: Complete 100 interventional procedures.
Time Limit: Three months
Rewards: One random attribute point, 10,000 experience points, one Diagnostic Assistance AI fragment.]
The quest the system had issued long ago began flashing, as though reminding Luo Hao not to forget it.
Oh?
Luo Hao’s worries vanished.
He had been especially afraid that the system would assign him a DSA intervention procedure.
Today, when he performed a uterine artery embolization for a patient with a cesarean scar pregnancy, his maternal uncle, Lin Yuming, had nearly fallen out with him.
If Luo Hao continued recklessly, he had no doubt that his uncle would become an insurmountable obstacle.
He would have to ease off for a while and find a chance to persuade him.
The system’s reminder had arrived at exactly the right moment. It seemed that, in some mysterious way, it understood his predicament and was suggesting that he perform a puncture procedure for a hepatic cyst.
The procedure was not difficult and carried almost no risk. Most importantly, it involved no radiation exposure.
The only question was whether the senior department heads would accept the new technique.
But with the director of the Medical Affairs Department backing him, that would not be a problem. The opinions of the senior directors were merely “for reference”—and they would also have to “refer” to Lin Yuming’s opinion.
In the past, Luo Hao’s impression of his uncle had been limited to the man’s indulgence toward him. But after returning to the Mining Hospital and working alongside him, Luo Hao had discovered that Lin Yuming was as fierce as a tiger and as cunning as a fox.
That was why Luo Hao had such confidence in him.
“Did you understand everything I explained to your family?” Dr. Jiang asked the patient, enunciating every word.
“We understood,” the patient’s family member replied miserably. “If we stay here for the operation, Director Wen will perform laparoscopic fenestration and drainage of the hepatic cyst. Doctor Jiang, did I get the name of the procedure right?”
“That’s right.” Dr. Jiang nodded.
The family member had clearly taken the matter very seriously. It was difficult for a layperson to recite such a cumbersome surgical term in one breath.
Apparently, they had not merely listened to him—they had gone online to look it up. And they had not stopped at a cursory search; the words were practically etched into their minds.
“Doctor Jiang, if we had the money, we would definitely listen to you.” The family member’s hands and feet fidgeted helplessly, as though he did not know where to put them.
He looked as if he had done something wrong, as though even breathing was a mistake.
“You’re welcome. Come in and sit down.” Seeing that the family member was polite, reasonable, and clearly not the sort of person who refused to bring his loved one to the hospital simply because it was inconvenient, Dr. Jiang softened his tone considerably.
The family member sighed and continued, “You said laparoscopy is also minimally invasive, but it costs more than the procedure you recommended. If we go to the provincial capital, we’ll have to queue for a hospital bed. Then there’s the food and lodging for whoever takes care of my wife. All of that costs money.”
“A neighbor of ours went to the provincial capital for surgery a while ago. The hospitalization alone cost more than forty thousand yuan, and the person taking care of him spent another thirty thousand on food and lodging.”
“How could it cost that much?” Even Dr. Jiang was stunned this time.
“They spent more than twenty days just waiting for admission. We had no idea when the head nurse might call, so we didn’t dare leave the provincial capital. We were afraid that if we went home, she would call the next day and tell us to come in immediately.”
“We didn’t dare stay anywhere too expensive, but the patient couldn’t recover properly without decent rest either… Ah. Home is comfortable no matter how long you stay; once you leave, everything becomes difficult. Whatever you do, you need money…”
“The procedure you recommended really wouldn’t cost much, and the new rural cooperative medical insurance would reimburse part of it. But we truly can’t afford the food and lodging.”
As he spoke, the family member seemed ashamed before Dr. Jiang. He bowed deeply in gratitude, his voice already choked with emotion.
“Thank you, Doctor Jiang. We may be country people, but we know who truly treats us well.”
Dr. Jiang frowned, apparently trying to remember something that would not quite come to him.
After a few seconds, he turned to Luo Hao.
“Xiao Luo, didn’t Obstetrics and Gynecology invite an expert from the provincial capital for a consultation a few days ago?”
“Yes.” Luo Hao nodded firmly.
Dr. Jiang did not continue speaking to Luo Hao. Instead, he rose and patted the family member on the shoulder.
“Up all night and unable to sleep—was it because you felt uneasy?”
The words struck the family member where it hurt. His eyes reddened.
“It’s all right. Go home and get some rest. We’ll discuss a better solution.”
The family member probably thought Dr. Jiang was simply placating him, but the decision had been his own, and he could not blame anyone else.
After expressing his thanks several more times, he left.
Dr. Jiang closed the door to the doctors’ office and regarded Luo Hao curiously.
“Doctor Jiang…”
“Call me Brother Jiang.” Dr. Jiang smiled. “Xiao Luo, I heard from the doctors in the ultrasound room that you performed some of the procedures.”
“Mm.” Luo Hao nodded. “I performed eleven of them. There’s nothing particularly difficult about the puncture technique. Brother Jiang, were you suggesting that the patient go to the provincial capital for ultrasound-guided puncture drainage and sclerotherapy of the hepatic cyst?”
“Director Wen insists on doing laparoscopic fenestration and drainage. I’m only an old attending physician; my words carry little weight. Even if I say something, it doesn’t count.”
“There’s nothing I can do.”
Dr. Jiang spoke casually, as if merely making conversation.
Had anyone else said those words, Luo Hao would have taken them as a complaint about the unfairness of the world. But coming from Dr. Jiang—even with his self-deprecating claim that he was merely an old attending physician—Luo Hao could hear a hint of expectation.
Nothing was said outright, but the two men understood each other.
“I’ll go back and ask around. I’m only a minor staff member,” Luo Hao replied, neither agreeing outright nor refusing, but giving a deliberately vague answer.
“I have a junior disciple.” Dr. Jiang changed the subject with remarkable speed. “The doctor who performed the appendicitis operation tonight—he’s quite capable, and his hands are skillful. Unfortunately, I’m no longer able to do much myself. He’s… rather straightforward. If you continue performing puncture procedures, you should take him along when you have the chance. He truly has a great deal of talent.”
“I’m only a small fry. We’re all in the same boat.” Luo Hao smiled broadly without committing himself.
Seeing that Luo Hao was not taking the bait, Dr. Jiang did not press him. He began writing the operative record instead.
Once Luo Hao had finished his work, he said goodbye and left.
A young doctor approached him as soon as he stepped outside. He was wearing isolation clothing and shuffling along in slippers.
He looked perfectly normal, except that… Luo Hao sensed something strange about him.
Out of habit, Luo Hao smiled at the doctor. Then, while taking out his phone to check the time, he walked away.
“Master, was the man who just left Luo Hao from the Medical Affairs Department?”
The young doctor entered the office and asked.
“Chen Yong, keep your voice down.” Dr. Jiang gestured. “Sit. I have something to tell you.”
Chen Yong removed one mask. There was another mask underneath.
Unfazed, Dr. Jiang took out a cigarette and tossed it to him. Then he lit one of his own and inhaled deeply.
“Master, what’s wrong?”
Chen Yong removed another mask. Astonishingly, there was still one more beneath it.
“Nothing. What do you think of the patient in Bed 3-8?”
“Hepatic cyst, already affecting liver function. The best treatment would be puncture therapy.”
Chen Yong removed the last mask. His face was handsome, with sharply defined features.
If he stood on a stage, that face alone would draw countless screams and cheers from the audience, generating a flood of attention.
“The patient’s family just told me that the transportation and living expenses would be too high if they went to the provincial capital. They’ve decided to stay here and undergo laparoscopic fenestration and drainage of the hepatic cyst.”
“!!!”
Chen Yong’s face filled with the indignation characteristic of youth.
“Master, your surgical skills are clearly the best in the department, yet the director has to be that Wen fellow. Why? Just because he’s a second-generation doctor?!”
“Don’t talk nonsense.” Dr. Jiang held the cigarette between his lips and glanced at the office door.
It was closed. Through the frosted glass, he could see no one outside.
Although it was deep into the night, Jiang Wenming remained extremely cautious.
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“Master, I’m telling the truth.”
“Even the truth can’t be spoken carelessly,” Dr. Jiang said. “Laparoscopic fenestration and drainage of a hepatic cyst is also a legitimate procedure. Choosing one technique over another involves medical judgment. It has nothing to do with the person performing it.”
“I’ll remember that.” Chen Yong lowered his head and spoke in a small voice.
Dr. Jiang smiled faintly at his young disciple.
“Luo Hao graduated from Peking Union Medical College’s eight-year program.”
“That doesn’t necessarily mean he’s all that capable. He’s just good at taking exams.” Chen Yong raised his chin stubbornly.
“I reported for duty in the outpatient clinic today. You should talk less in the department. If you get the chance—for example, if Luo Hao contacts an expert from the provincial capital to operate on the patient in Bed 3-8—you must build a good relationship with him.”
Chen Yong curled his lip.
“We’re both young. We can go to an Internet café and play a few rounds of King of Glory, then go out for skewers and drinks. Once we’ve had a lively evening together, the relationship will naturally improve. Is there anything simpler than that?”
As he spoke, Dr. Jiang’s tone grew stern and reproachful.
“Invite an expert to perform surgery? What kind of surgery?” Chen Yong asked.
Dr. Jiang knew Chen Yong was unwilling, and he also knew that the young man was not the sort to do such a thing. He smiled faintly and used Chen Yong’s question to steer the conversation elsewhere.
He told him about the recent case in Obstetrics and Gynecology, in which an outside expert had been invited to perform puncture drainage and sclerotherapy for an ovarian cyst.
“I didn’t see it myself. I only heard that Director Sun made a few casual remarks while performing the operation. It was secondhand information, so it may not be reliable. But Luo Hao assisted me today, and I thought he operated quite well.”
“Oh? Better than me?” Chen Yong was like a newborn calf, eager to butt at anything he saw.
“Heh. You’ll know once you’ve seen him.” Dr. Jiang gave no direct answer. “Assisting at surgery is the best way to reveal a doctor’s technique and awareness. Sometimes, a good assistant can make an operation fly.”
“My operation flew today.”
“!!!”
Unconvinced, Chen Yong looked up at Dr. Jiang.
“That’s a minor matter. As for future surgery… Unless the progress of technology is interrupted by war or some other force beyond human control, surgery will inevitably move toward minimally invasive techniques. In the medical field today, endoscopic surgery and the da Vinci robotic system have already replaced a considerable portion of conventional operations.”
“That is the broad direction of the future. It will not be altered by anyone’s will.”
“We’re a small hospital. Our technical level is below the national average, to say nothing of comparing ourselves with the imperial capital or the magic city. You have talent. If you intend to pursue medicine, Luo Hao would be an excellent choice.”
As he spoke, Dr. Jiang laughed at himself.
“I’m only offering you a suggestion. Who knows how far you’ll actually go? What I mean is, if I were your age and happened to meet Luo Hao, I would consider building a good relationship with him and working together.”
Chen Yong frowned. A trace of stubbornness flashed across his handsome face.
…
Early the next morning, Luo Hao stood spiritedly outside the director of the Medical Affairs Department’s office.
Lin Yuming was envious.
He had been up half the night and gone home to catch a little sleep. Now, he was nowhere near as energetic as he had been before.
Luo Hao, however, was different. The kid had barely slept all night, yet he remained full of energy, showing no sign of fatigue.
Back then…
Lin Yuming’s thoughts drifted back more than twenty years.
“Director Lin, I’ve finished reporting on yesterday’s events.” After giving a concise account, Luo Hao wore an expression of hesitation.
“What else is on your mind?” Lin Yuming asked.
Noticing Luo Hao glance into the office, Lin Yuming turned and walked inside. Luo Hao followed close behind.
After closing the door, Luo Hao told him about the patient he had seen in General Surgery.
“Uncle, I can perform this operation.” Luo Hao grinned.
“You already promised Jiang Guangming?”
“Uncle, I didn’t promise him anything. I’m only a minor staff member—how could I make a decision on my own? The operation went smoothly, but I know that happened because the department heads were giving you face. Even so, I feel that I’ve already encountered resistance in Obstetrics and Gynecology. I can sense it.”
“So you do know.” Lin Yuming sat in his chair, resting both hands over his lower abdomen while his thumbs slowly circled one another.
“I only have a vague feeling.” Luo Hao smiled. “Uncle, according to the books, what I’m doing is cutting off someone else’s source of income. That kind of grudge is on the same level as killing someone’s father or taking his wife, so I didn’t dare say much.”
Lin Yuming was somewhat surprised.
The boy had a good eye and understood the limits of rank and circumstance. He could actually see through so many things.
And he was not boastful in the slightest, remaining extremely low-key. That was remarkably difficult for a young man.
Showing off one’s achievements was such a common human impulse that it had become a fixed expression in the language.
If Lin Yuming had been that age and solved a difficult problem for Obstetrics and Gynecology, performing eleven procedures in a row, his own pride would have reached the heavens.
He would have kicked every dog he saw in the hospital. Forget modesty or restraint.
“I’ve been thinking that the treatments for hepatic cysts, renal cysts, and ovarian cysts are similar. We could combine them and develop a unified approach.”
After finishing, Luo Hao added, “It’s minimally invasive, reduces medical-insurance spending, and allows patients to recover quickly…”
As Luo Hao spoke, he saw Lin Yuming begin preparing tea. His voice grew solemn.
“The key point is that it requires no sutures.”
Lin Yuming gave Luo Hao a deep look. For several seconds, he could not determine whether the young man was threatening him.
“Uncle, the patient’s family in General Surgery last night clearly understood the situation. They simply don’t have the money to go to the provincial capital. I took a quick look—the core DIP score for laparoscopic fenestration and drainage of a hepatic cyst is 1,720. If the problem can be solved with puncture, that would save the medical-insurance fund some money, wouldn’t it?”
“Don’t play little games with me,” Lin Yuming said.
“Yes, yes.” Luo Hao stood obediently and properly before him.
“This matter has to be tackled at the source first.”
“Tackled?”
“This afternoon, I’ll take some people to General Surgery and clarify the medical-insurance policy.” Lin Yuming paused. “But that is only a temporary measure. We need to stabilize the flow of patients at its source.”
“Ultrasound?!”
“Exactly.” Lin Yuming nodded. “The ultrasound room is an upstream department. When I have time, I’ll invite Director Li from Ultrasound to dinner. You’ll come along.”
“All right, Uncle.” Luo Hao glanced at the quest timer in the upper-right corner of the system panel. He was in no hurry.
“You’re working in Obstetrics and Gynecology now. Don’t let your thoughts wander. The greatest danger for a doctor is having too much empathy. For example, when you see a poor patient who can’t afford to go to the provincial capital, once you…”
Luo Hao was inwardly delighted.
A few days earlier, one patient had received treatment precisely because of Lin Yuming’s compassion. Yet now, standing before him, the man was delivering one grand principle after another.
Luo Hao did not argue. He merely listened quietly.
At the same time, Director Sun of Obstetrics and Gynecology sat in her office with a deeply troubled expression.
“Big Sis, we grew up together. Don’t lie to me.”
A woman sat on the bed in Director Sun’s office, her face filled with confusion.
Director Sun looked at her cousin, who was completely “ungrateful,” and felt unable to voice her bitterness.
“Sis, I heard that your department performs puncture procedures for ovarian cysts, and afterward…”
“What about afterward?” Director Sun asked disdainfully.
“They were talking nonsense, saying patients could walk back to the ward. My friend didn’t believe it, and neither did I. How could an illness be cured without any pain or discomfort? But strangely enough, after she was discharged, she went to three different places for follow-up examinations, and all of them said the cyst had disappeared.”
“Hmph.”
“Sis, I’m timid. I’ve had this ovarian cyst for several years, and it’s grown larger every year. I can’t keep putting it off, so I came to you. But…”
“Do you trust me or not?” Director Sun asked.
“Of course I trust you.”
“Then let me put it this way: that operation was performed by the nephew of our hospital’s director of Medical Affairs. Do you really think it was any good?” Director Sun said contemptuously. “If the procedure were truly so effective, why wouldn’t I perform it myself?”
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“Ah!” Director Sun’s cousin exclaimed in surprise.
“Of course it’s true. Would I harm you? We’re family. I recommend that you undergo minimally invasive surgery. I’ve been performing that procedure for more than ten years, on over a thousand patients. It’s extremely well established. I make a recommendation and you refuse to follow it, insisting on listening to other people’s nonsense. Honestly, you…”
Her cousin’s face flushed scarlet under the scolding.
She studied Director Sun carefully before finally saying, “Then I’ll trust you.”
“That’s more like it.” Director Sun smiled.
Her cousin’s resistance completely disappeared, along with the aggressive attitude she had displayed earlier.
When gentle persuasion failed, a few harsh words were necessary, Director Sun thought.
But she herself felt conflicted.
The puncture procedures had been performed by Deputy Director Liu and Luo Hao. Director Sun only knew how to perform endoscopic surgery. She also knew that the new technique might be better, but since she could not perform it herself, she kept reassuring herself that puncture procedures were prone to recurrence, that undergoing one was practically the same as not being treated at all, and that offering it would be irresponsible toward the patient.
Damn it!
After seeing her cousin off, Director Sun cursed inwardly.
When she returned, she called Luo Hao out.
“Xiao Luo, are you making preparations to invite a professor to perform the operations? How many patients do you have lined up?” Director Sun tried her best to put on a kind and benevolent smile.
Before Luo Hao could answer, an Obstetrics and Gynecology doctor rushed out of the ward.
“Director, the patient is convulsing!”
Director Sun’s expression changed. She had no time to speak with Luo Hao and hurried toward the ward.
Luo Hao did not follow immediately. He stood rooted to the spot.
Ding-dong!
The system’s voice rang in his ears.
[Emergency Quest: Skeletal Hunger
Quest Objective: Treat convulsions in a patient who has undergone an induced abortion.
Time Limit: Five days
Rewards: 10,000 experience points, one point of Peer Admiration.]
The quest was strange, and Luo Hao did not understand what the system was trying to say.
Peer Admiration? What use was that? Luo Hao frowned slightly.
His mother had always been a discreet person. She never showed off or sought attention. Luo Hao had been subtly influenced by her since childhood and had developed a restrained temperament of his own.
For him, one point of Peer Admiration did not mean much.
He did not mind having talent that went unseen.
What puzzled him was the name of the quest: Skeletal Hunger. What did it mean?
Full of doubt, he went to the ward. At the doorway, he saw a nurse attaching the pregnant woman to a cardiac monitor.
Her vital signs were stable, but foam was bubbling at the corners of her mouth, and her hands and feet were convulsing intermittently.
Director Sun stood beside the patient, apparently deep in thought. Yet the expression on her face always gave Luo Hao the strange impression that her mind was completely blank.
The patient was not in immediate danger, and there were already plenty of people tending to her. Luo Hao glanced at the bed number, then quietly withdrew and returned to the doctors’ office.
He opened the medical record and read it carefully.
The patient was a thirty-three-year-old woman admitted to the Mining General Hospital after being transferred from a lower-level facility. She had been amenorrheic for nineteen weeks and three days, with three months of nausea and vomiting that had worsened over the past three days.
Among her examination results, the serum calcium level was above 3.49 mmol/L. Urinalysis showed weakly positive ketone bodies. Her electrocardiogram showed first-degree atrioventricular block and ST-T changes in some leads.
After admission, the Obstetrics and Gynecology Department had administered fluid expansion, diuresis, and calcium-lowering treatment, but the results had been unsatisfactory. Then, today, the patient developed convulsions.
After finishing the medical record, Luo Hao glanced again at the system quest—Skeletal Hunger.
Her calcium level was high. It seemed related to the bones, but he could not understand exactly how.
The system interface offered no diagnosis. Its background had turned dark red and was flashing faintly. A line of text appeared below:
Insufficient auxiliary examination data. Unable to diagnose.
Unlike before, however, the system provided a recommendation after declaring that it could not make a diagnosis:
Recommended examination: thyroid ultrasound.
What?
Luo Hao froze for a moment.
Could there be a problem with the patient’s parathyroid glands?
The parathyroid glands were closely related to calcium ions in the human body, regulating calcium and phosphorus metabolism. If something went wrong with them, the calcium concentration would change.
Because the condition was rare and not commonly encountered in clinical practice, many doctors overlooked it.
During his internship, Luo Hao had once encountered a cancer patient whose follow-up examination at a local hospital revealed hypercalcemia. The patient’s family, fearing metastasis, had booked an appointment online with an expert at Peking Union Medical College Hospital.
At the time, Luo Hao’s supervising physician had ordered several tests, one of which was a thyroid ultrasound.
The final diagnosis had been a parathyroid lesion, and his supervisor had explained several related cases to him.
Prompted by the system interface and guided by his own reasoning, Luo Hao gradually arrived at an answer.
“Notify the ICU. Whether they have a bed or not, transfer her there!” Director Sun’s shrill voice rang out.
She was panicking.
Luo Hao could distinguish the panic and helplessness in her voice.
Transferring a critically ill patient to the ICU was also one of the most commonly used methods of shifting responsibility in clinical practice, and Director Sun had mastered it thoroughly.
“How can the ICU say they have no beds for such a serious patient? I don’t care!”
Her voice drew closer.
Soon, she strode into the office and stared at Luo Hao with an ashen face.
“Xiao Luo, help me transfer the patient to the ICU,” Director Sun said directly.
Luo Hao knew that, at a moment like this, the Medical Affairs Department carried considerable weight.
But weight was one thing. He did not want to do it.
“Director Sun, you mean the pregnant woman who’s having convulsions?”
“Yes! She was perfectly fine, and then suddenly she started convulsing. What is going on?”
Luo Hao stood up.
“Director Sun, I’ll perform an ultrasound first. Then we can decide what to do.”
“An ultrasound?!”
Director Sun stared at him in disbelief.
Was he joking? The patient had suffered no trauma. She had begun convulsing for no apparent reason, and Luo Hao wanted to perform an ultrasound.
He must only know how to do ultrasounds. Unable to think of any other solution, he had instinctively reached for the procedure he was familiar with.
If he delayed the patient’s treatment, could Luo Hao afford to take responsibility?
“Luo Hao!” Director Sun’s voice became even sharper.
“Mm?”
“Are you making this decision on behalf of the Medical Affairs Department?” Director Sun demanded, deliberately trying to pin responsibility on him.
“Yes.” Luo Hao answered calmly. “I am representing the Medical Affairs Department.”
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