143 – An Ally

The atmosphere at Qinbei Hospital felt different from usual. 

“What’s going on?” asked Fan Geng as he arrived early in the ER for his morning shift.

“The hospital is preparing for the arrival of VIPs,” said Dr. Wei Bing, another newly appointed resident. “Don’t you ever check your email?”

Fan Geng shrugged. “Why do I need to read email when I can ask you?”

Wei Bing sighed, this idiot was a pain to deal with. “Academician Tan and Minister Yue are both coming.”

“Gee, and I thought it was some big time celebrity.”

Wei Bing rolled her eyes. “Minister Yue is the guy in charge of almost all the major changes to health regulations, that is huge! More important than any celebrity you see on TV.”

Fan Geng shrugged. He didn’t care much about policies. “Why are they here?”

“Minister Yue has liver cancer, and he’s seeking Dr. Li for treatment.”

“The quack?” Fan Geng pulled back his face. 

He wasn’t completely out of the loop when it came to Li Yun. He was aware that the guy had a good reputation as a surgeon and he himself had watched a couple of surgery footage, but it didn’t mean he had to like the guy. There was something about that quack that made him feel uneasy. It was like being naked on a spotlighted stage with the parents sitting in the front row.

“I’m going to head to the conference room to watch, they are going to have an interdisciplinary pre-surgery meeting in the main lecture with all the surgeons,” Wei Bing walked further down the hall.

Fan Geng decided to follow since the early morning had few incoming patients. As they walked down, they greeted quite a few department heads who were also heading to the lecture hall.

“Damn, it’s going to be crowded today,” Wei Bing said as she looked at the large lecture room, already filled with residents and attendings.

The seats were reserved for attendings, and everyone else had to stand. In the front row were Director Hong, the chiefs, and Li Yun.

Fan Geng stood by the side and waited for the VIPs’ arrival. They didn’t expect the arrival of an entourage, all heavy hitters from Magic City. Director Hong and Chief Zhang greeted the incoming VIPs, escorting them to the front of the room.

Fan Geng lit up the moment he saw Academician Tan. The academician greeted everyone but neglected Li Yun.

"An ally!" Fan Geng thought.

While everyone was relatively cordial, Academician Tan did not hide his scorn toward Li Yun.

Minister Yue pushed Academician Tan aside and warmly shook hands with Li Yun. "Dr. Li, thank you for taking on my case."

Li Yun smiled and nodded. The handshake told Li Yun enough about Minister Yue's condition that he felt a bit more assured about his surgical plan. Dr. Kong and Dr. Yue also greeted Li Yun afterward, but Dr. Yue wasn't rather cold.

"Another ally!" Fan Geng thought in his head.

After the introduction, everyone took a seat and focused on the large screen displaying a CT image of Minister Yue’s liver.

“As you can see, there are two tumors located in non-adjoining segments, making it ineligible for a surgery.” Academician Tan pointed to the two locations with the digital pointer. “The 2nd tumor is close to the vena cava, and should be addressed as soon as possible. I heard that Dr. Li is suggesting either TACE (trans-arterial chemoembolization ) or radioembolization?”

Li Yun nodded. “But after the physical checkup, I do not think TACE is advisable with Minister Yue’s condition. There is a high probability of an acute pancreatitis after surgery. I also recommend a central hepatectomy to remove the cancerous tumor."

Academician Tan was not opposed to the plan. Radioembolization was good for delaying the spread and growth of existing cancer cells. However, a central hepatectomy on the second tumor was a dangerous procedure as it was too close to the vena cava.

“Is there a reason why you think it is necessary to have a partial resection over waiting for a liver transplant?” Academician Tan did not like the idea of a resection. Partial resection did not guarantee the removal of all the cancerous cells and increased the risk of complications down the road. He had advised Minister Yue to wait for a liver transplant, but the man was too stubborn.

“I understand that there are risks involved with the resection, but I can guarantee that we can remove all the tumors," Li Yun said confidently. "First, I will perform the radioembolization to stop the blood supply into the first tumor and minimize blood loss during the resection.”

“You’re planning to perform both at the same time tomorrow?” Asked Academician Tan.

Li Yun nodded.

They still had to make the decision on how to approach the surgery and thought that scheduling the surgery for the following day was too hasty. Everyone had not yet agreed on the partial resection.

Li Yun had never tried to radioembolization on tumors, but it should be as simple as other embolization procedures to prevent blood loss. The main difference was using yttrium-90 to block the blood vessels from entering and feeding the cancerous tumors. He had performed several hepatectomy on trauma patients, so he was comfortable with the anatomy.

“Minister Yue is not in a condition for open surgery.” Many doctors from Minister Yue’s team were still concerned.

“Not open surgery, laparoscopic hepatectomy,” Li Yun corrected them.

The doctors were even more shocked.

“How are you going to completely remove all the tumors with limited field of view?” Dr. Yue thought the young doctor was being arrogant.

“Experience, I am sure many of you are aware that my expertise also includes TCM. I have a more holistic view of the body and how to gauge its function. Even if we miss something, the body system will be able to handle the rest on its own.”

There were some doctors who were hesitant about the plan. Although it was a common treatment plan, the chances of recurrence were also very high within the next five years. There was a better prognosis with a liver transplant.

However, Minister Yue had already approved of the plan. "We will proceed with the procedure tomorrow," the minister declared, stamping his cane on the floor.

The following afternoon, everyone was waiting for the surgery to begin. It was the same as before, the conference room was packed with doctors waiting to see the operation.

If Dr. Li performed well, it may potentially raise the reputation of the hospital. As the reputation improved, it meant more resources for everyone else. Although not everyone liked Li Yun, they couldn’t deny his influence.

Qinbei Hospital wasn’t the best known hospital in the country, but the ER had gained a bit of reputation after Chief Zhang took over. In addition, there was a specialist who was in charge of surgery without the use of a dyeing agent and in rare cases, certain types of anesthesia. His name was slowly making a name in the field of vascular and interventional surgery.

“This must be the most exciting surgery since we started!” Said one of the new residents.

“The hospital is really trying to make this big since Minister Yue has allowed it to be publicly broadcasted.”

Fan Geng rolled his eyes. If it was anything like it was rumored to be, then it wasn’t like any of them was able to discern what was going on. Li Yun’s surgeries were known as the invisible hand, as no one was able to see what was going on until the CT scans were revealed after the surgery.

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