CH 30

When Jiang Xu went to the ward, Ma Hao was peeling an orange for Ruan Xufang, and when he saw him come in, he immediately put down the fruit and wiped his hands with tissue.

“Doctor Jiang.” He sat up from the small chair beside the bed and looked at Jiang Xu with a twinkle in his eyes.

Ruan Xufang looked to be in a much better state, she was originally lying on the bed, but now she also sat up and said respectfully, “Doctor Jiang.”

Jiang Xu nodded and didn’t beat around the bush, “Eat your oranges first, then come to me later to discuss the surgery plan.”

Ma Hao and Ruan Xufang clearly didn’t have the heart to eat oranges any more. Jiang Xu had just gone to call Shao Le and a new graduate student on rotation when he saw the two standing at his door.

With a folder in his hand, Jiang Xu waved at the two and led Shao Le and the graduate student into the conference room.

“Have a seat.” He said to the two, flipped open the folder and said to the graduate student beside Shao Le, “Xiao Wang, give a brief description of the condition.”

Xiao Wang had obviously prepared, and although he was a little nervous when he spoke and kept stumbling over his words, he made all the points he needed to make.

Jiang Xu gave an “mmm”, and Xiao Wang let out a sigh of relief.

He took out the checklists and case reports from the folder and placed them one by one in front of Ruan Xufang. Seeing Ma Hao trying to look this way, he pushed a few pages slightly that way so that he could see them more clearly.

He laid them out while explaining the situation to the two of them. Ruan Xufang and Ma Hao had both eased up from their emotions of the bad news and were listening very carefully. In addition, he replaced some incomprehensible terms with words Ruan Xiufang understood.

“Doctor, can I really live for a long time?” She had listened to Sister Cai’s reassurance and heard Ma Hao say it once more, but when it came to life and death, she couldn’t help but repeatedly confirm it as she looked at Jiang Xu, who was in a white lab coat.

“There are no medical absolutes,” Jiang Xu said, “but as far as the statistics go, the prognosis for any early stage cervical cancer is not too bad.”

With the basics out of the way, he cut to the chase, “The main reason I called you today is to talk about the choice of surgical procedure.”

In Ruan Xufang’s case, there were two options, cervical conization or total hysterectomy. As the names suggest, the former only removes the cervix and the latter removes the whole uterus.

Ruan Xufang already had a child and Jiang Xu confirmed that she had no desire to continue having children before continuing, “In this case, we usually recommend total hysterectomy for a better prognosis and, according to statistics, a lower probability of recurrence.”

“Total hysterectomy ……” Ruan Xufang was a little hesitant, “Then I won’t have a uterus.”

“The main function of the uterus is to nurture a fetus, don’t worry, it won’t affect your normal life.” Shao Le took over.

Ruan Xufang looked at Shao Le, “But, Dr. Jiang …… Dr. Jiang just said that conization is the removal of the cervix ah.” She said and was a little confused.

“As far as the current pre-operative assessment is concerned, your case is consistent with the indications for conization,” Jiang Xu said, “but it carries a greater risk.”

To put it bluntly, a malignant tumour can be cut out once it has grown into a visible mass, but there may still be some invisible tumour cells that may recur later.

For an organ like the uterus, which is not considered essential for survival, total excision is the safest treatment. It is one of the reasons why the prognosis for cervical cancer is better than that for other cancers of vital organs.

Ruan Xufang lapsed into silence at his words and stopped asking questions, as if she had understood what Jiang Xu meant.

“The current arrangement is to have radical surgery first, and then there will be three stages of radiotherapy and chemotherapy. The first stage will be done in our department, after which Shao Le will arrange for you to be transferred to the oncology department.” Jiang Xu asked, “Are there any other questions?”

“Doctor ……,” Ruan Xufang mumbled after a long time, “I still want…to keep my uterus.”

Jiang Xu glanced at her, the the fountain pen in his hand drew a line on the paper, which he handed to Ruan Xufang, “Conization needs to be followed by three stages of radiotherapy, the cut tissue will be sent to pathology intraoperatively, if the cut edge tests positive, it means there are traces of tumor cells and another cut is needed.”

A positive cut margin, to be considered an invasive carcinoma, would require a redefinition and judgement of Ruan Xufang’s staging, and perhaps further lymph node dissection and bilateral adnexectomy if things were not ideal.

Ruan Xufang shook her head, “But doctor ……” she hesitated a little, “Without a uterus, I’m not a woman anymore.”

Jiang Xu’s eyelashes suddenly trembled.

This time, without waiting for Jiang Xu to speak, Ma Hao spoke first, “Aiya, wife, life is the most important thing at all times, what will you need a uterus for is your life is gone, who dares to say you are not a woman, I will go and beat the hell out of him.”

Jiang Xu took the pen and glanced at Ruan Xufang.

“Estrogen in the ovaries is what supports your secondary sexual characteristics,” he said, “If things go well during the operation, we’ll try to preserve your ovaries as much as possible.”

“That’s different, doctor,” Ruan Xufang said bitterly, “I just feel uncomfortable. If I have to cut it to live, then so be it, but right now, I have another option so I’m willing to take the risk.” She said, “I am not the first to have this operation, how could I be so unlucky as to have a relapse?”

Jiang Xu nodded at her words and told Ruan Xufang again about the various precautions and the advantages and disadvantages of the two types of surgery, “You can go back and discuss it, and decide when I come to check on you tomorrow morning.”

He closed the folder, put the pen back into his jacket pocket and walked out of the meeting room.

Xiao Wang followed behind Shao Le, he had not been here long and knew that Jiang Xu had always been strict, so he did not dare to ask him directly but lowered his voice and asked Shao Le beside him, “Sister Shao Le, is Mr. Jiang just going to leave and not persuade them?”

Shao Le shook her head, remembering that when she first came here, she also had this kind of doubt. But Jiang Xu just told her to tell the patients what she should tell them. Just like the uterus, one might think it is important, but in some people’s hearts, it is very important. Everyone’s needs are different, doctors should never judge others by themselves, they should give priority to the needs of the patients.

Especially with a disease like cancer, which is closely related to mental health and mental state. If a patient is so resistant to a surgical method like Ruan Xufang, even if you do a full incision for her safety, she may be depressed and most likely relapse.

She still remembers when Jiang Xu received an old woman with vaginal warts, everyone else thought that the old woman was so old and naturally didn’t care too much about scar repair, but Jiang Xu remembered to ask the old woman if she still had a need for sex in the future, and to her surprise, the old woman with white hair really nodded, so the surgery team changed the procedure urgently.

Most people are prone to judge others by their own feelings or worldly perceptions, but there are thousands of personalities, and the most important thing a doctor should do is to consider the patient’s needs.

She whispered those past stories to Xiao Wang, who nodded thoughtfully and looked at Jiang Xu’s slender back.

Jiang Xu’s mind kept dwelling on Ruan Xufang’s remark just now, and he was rarely distracted, not hearing what the two were discussing. He returned to the workstation to put down the folder and drank some water. The glass of water was left for too long, so it was a little cold. He added some warm water to it, drank two sips, and felt particularly tired.

Although the baby was only three months old, it was still heavy to carry around all the time. He rubbed his sore back and sat in the chair for a while, his gaze somewhat vacant. After recovering his strength for a while, he got up and went to his car in the parking lot.

When he arrived home, he inserted the key into the keyhole with the subconscious intention of turning it twice, but to his surprise, the door opened after just one turn. He saw the light on in the living room and suddenly remembered that he was now staying with another person.

It felt novel and a little strange.

It seemed like a long time since he had last opened the door to a well lit home.

Shen Fangyu was on a video conference. He nodded slightly when he saw him return, took off half of one of his earphones and after confirming that Jiang Xu had nothing to say to him, put it back on and moved his eyes back to the computer screen.

He looked very focused when he was working, and would say a few words every now and then. Jiang Xu listened and realized he was instructing a student on a subject.

In fact, this was Shen Fangyu’s normal state, but the playful Shen Fangyu was so present these days that Jiang Xu felt a little strange when he first saw him like this.

Putting aside the subtle emotions in his mind, he put down his bag and changed into his slippers, turning to the bathroom to take a shower.

The scalding hot water hit his body, creating a milky white mist that blurred his vision.

A whole day of surgery, bloody entrails, a baby, a ticket from the administrative office, soup that had cooled and been reheated, the faces of Ruan Xufang and Ma Hao, and the look Shen Fangyu had just given him when he took off his headphones.

The complex images swept past Jiang Xu’s eyes one after the other, both vague and bizarre.

For some reason, he suddenly felt tired.

As he stood in front of the mirror blow-drying his hair, Jiang Xu took his other hand and wiped off a thick layer of moisture from the mirror, revealing his face.

Even though he wasn’t overly conscious of his appearance, Jiang Xu still noticed that he had lost some weight, and the contours of his cheeks looked more defined than before, with the line of his jaw being particularly pronounced.

By some strange coincidence, he had wiped the mirror until it showed the full upper half of his body.

He saw something and Jiang Xu’s grip on the hair dryer suddenly loosened and the hairdryer fell to the floor. The plug separated from the socket with a clattering sound of electric sparks.

The bathroom, which was filled with the noise of the hair dryer, suddenly fell silent, and Jiang Xu heard a voice from the living room, “What fell?”

Jiang Xu ignored it, his half-wet hair plastered to his scalp, the ends still dripping with water.

He lowered his eyes, the moisture staining his eyelashes and making them look extraordinarily thick and black like ink. Jiang Xu’s gaze fell on his abdomen in the mirror, an inexplicable look in his eyes.

There was already a slight outline of the three-month-old pregnancy on his stomach, not visible when he was wearing clothes, but barely visible when he was naked like this.

Ruan Xufang’s words echoed in his mind again, the woman’s sigh still in his ears.

—“Without a uterus, I’m not a woman.”

What about having a uterus?

Jiang Xu looked in the mirror.

“What am I?” Jiang Xu asked himself this question for the first time since confirming that he was pregnant.

It wasn’t that he hadn’t thought about it before, but every time the thought popped up, he tried to nip it in the bud, not daring to think about it for a second. He even avoided looking at his changing stomach.

But this time, perhaps because he was too tired, or because Ruan Xufang’s words had silently cut a hole in his heart, the emotions he had suppressed for so long came crashing down, and he finally couldn’t help but ask himself this question.

——What am I?

Jiang Xu looked at himself in the mirror, not daring to answer.

In the silence of the stalemate with the person in the mirror, a random thought suddenly popped into his mind.

If Shen Fangyu were here, he would have laughed and then teased him about his inability to handle pressure, and with a cynical smile, smash the mirror.

So Jiang Xu did just that.

With a loud “bang”, the mirror in front of him split in two, one part fell to the ground and another part stayed in place with numerous cracks appearing.

Jiang Xu glanced at his bleeding hand and then at his shattered face in the mirror.

Then in the depths of silence, he heard the sound of hurried footsteps coming over.

They followed his heartbeat, each step becoming clearer and clearer as they came closer.