Volume 1: Rise
Transplant
Without a heart transplant soon, Miaomiao… won’t survive this winter.
CCU.
Cardiovascular Intensive Care Unit.
Lu Qingshi changed into isolation clothing and walked in. The glass shielding door automatically opened before her. A passing nurse bowed her head and greeted her, “Good day, Director Lu.”
She picked up a medical record from the triage desk in the central monitoring room and flipped through it, “How is the patient in bed 11 today?”
“She had a slight fever this morning, reduced urine output, and experienced an arrhythmic fainting episode yesterday but was resuscitated,” the nurse said with a heavy sigh. “If we can’t find a suitable donor for a heart transplant soon, this child, alas…”
Lu Qingshi closed the medical record and walked towards bed 11. Through the glass, she could see that someone was already inside. A woman wearing a white coat with an isolation gown over it sat by the bedside, chatting and laughing with the child.
Qin Xuan had brought the child a pink stuffed toy, popular among young girls these days. Of course, it had to be strictly cleaned and disinfected before being brought in; even the slightest bacterial infection could be fatal for He Miaomiao.
The child had an IV drip attached to her hand and various monitors tracking her vital signs connected to her chest. Although her small face was pale, she still smiled genuinely when she saw the gift.
“Dr. Qin always brings gifts for Xiaomiao. We don’t know how to thank you enough…”
Mrs. He stood there rubbing her hands, looking somewhat uneasy. The He family was not financially struggling; both parents were from Jinzhou City. One worked in a government department, and the other was a high school teacher. He Miaomiao had been admitted to the neonatal intensive care unit1 at Renji Hospital right after birth. After completing the three stages of the Norwood procedure2 and stabilizing, she was transferred to the CCU. Since then, the family has been constantly traveling between home and the hospital, and it has been five years now.
Yet, there are some illnesses that money cannot cure. He Miao was diagnosed with Hypoplastic Left Heart Syndrome (HLHS) at birth.3
This was her third year waiting for a heart transplant.
Qin Xuan smiled as she comforted them, “After all, I’ve watched Miaomiao grow up. I remember when I first carried Miaomiao out.”
She gestured in the air, “She was only this small, and now, oh my goodness.”
She laughed and patted Miaomiao’s head, “Yesterday, the nurse measured your height, and you’re already 90 centimeters tall. Your hospital gown is even short!”
Although this height is still below average compared to normal children, Miaomiao’s safe growth to this size is due to the meticulous care of her parents and the efforts of many healthcare workers.
Both Mr. and Mrs. He smiled, hiding their heartache.
Soon, visiting hours were over. As they got up to leave, Mrs. He quietly wiped away a tear and, bending down, gently kissed her daughter’s forehead through her mask.
Qin Xuan squeezed Miaomiao’s little hand, “Miaomiao, be a good girl and listen to the nurse. Next time, Auntie Qin will bring you a Frozen cartoon drawing.”
He Miaomiao nodded vigorously, then shook her mother’s hand, “Mom, mom, when I get better, I want to take the cartoon drawing Auntie Qin gives me to kindergarten to share with my friends.”
The year she had just completed the Norwood procedure was her best recovery year. She had briefly attended kindergarten for three months. Although now she can only stay at home or in the hospital, Mrs. He knows her daughter desperately wants to return to kindergarten, to attend classes and play with everyone.
What is a mundane daily routine for ordinary people is an unattainable, fairy-tale-like dream for He Miaomiao.
Mrs. He held back her tears with great effort, nodded heavily, and kissed her daughter’s cheek again. Mr. He supported her as they walked out, while Qin Xuan waved to Miaomiao from outside the glass door.
Turning around, Lu Qingshi was also there.
“Aren’t you going in?”
Lu Qingshi shook her head, “No, I won’t.”
Qin Xuan pouted, “You’re such a softie with a tough exterior. Eight out of ten times I come, I see you standing outside the door.”
For once, a rare glimpse of embarrassment appeared on Lu Qingshi’s usually stoic face, as if her secret had been exposed. She snapped the medical record shut and placed it on the triage desk with a loud smack.
“I’m heading back to the emergency department.”
(If you're not reading on littlepandatranslations.com, it means this has been stolen)
Qin Xuan caught up and pressed the elevator button. Only when the elevator doors closed did a hint of sadness appear on her face. “If we can’t find a heart transplant soon, Miaomiao… she won’t make it through this winter, will she?”
Ten days after Miaomiao was born, she underwent the first stage of the Norwood procedure, which combined the main pulmonary artery with the underdeveloped ascending aorta.
Six months later, she had the Hemi-Fontan procedure, connecting the superior vena cava to the pulmonary artery.
A year later, she successfully completed the Total Cavopulmonary Connection (TCPC), connecting the right atrium to the right pulmonary artery. The entire systemic circulation relied on the right ventricle to maintain, and under prolonged systemic circulation pressure, the right ventricle gradually became exhausted. A year ago, she developed heart failure and was readmitted to the CCU.
Lu Qingshi didn’t respond. The elevator arrived at the emergency center, and she stepped out. Qin Xuan held the closing elevator door, “Still no suitable match?”
Lu Qingshi shook her head. Her thin silhouette disappeared into the hospital’s pristine white corridor.
“Hey, newbie, go change the medication for bed six. I’m swamped over here,” Hao Renjie said while filing his nails.
Yu Gui scampered off to do as instructed, returning in less than two minutes.
“Doctor, doctor, the patient in bed 3 had an accident and soiled the bed!”
“Isn’t there a caregiver for that?!”
“Aren’t you free? Come over and help turn the patient!” Yu Gui resigned herself to the task, pinching her nose as she hurried over.
Soon, it was lunchtime, and the office gradually emptied out. Yu Gui also planned to head to the cafeteria for a meal before coming back.
“Hey, newbie, organize these medical records for me, will you? The medical office needs them tomorrow,” a colleague said, placing a stack of neatly clipped files in front of her.
“But… but…” Before she could refuse, the colleague had already walked away. Yu Gui could only sigh heavily and sit down.
“But… I haven’t even had lunch yet.”
While working on the medical records with a growling stomach, she took advantage of the empty office to make a phone call to Fang Zhiyou. She picked up quickly, her familiar gentle voice coming through, “Xiaogui?”
Yu Gui responded softly, rubbing her stomach and complaining quietly to her girlfriend, “I haven’t had lunch yet, Zhiyou.”
“What do you want to eat? I’ll order it for you,” Fang Zhiyou, leaning against the flimsy bed frame in their small rented room, smiled as if she had the whole world.
“No, it’s okay. I’ll go to the cafeteria later,” Yu Gui knew that Fang Zhiyou didn’t earn much, yet she often treated her to nice meals. Feeling touched, her eyes welled up slightly.
“Zhiyou, I miss you.”
If she could, she would love to pat her head, just like she used to do back in school. But as she reached out, her hand only passed through the sunlight streaming in from the window, unable to grasp anything.
“Be good,” Fang Zhiyou smiled slightly, her lips curving gently. She had her entire month’s salary in her pocket, planning to use it to surprise Yu Gui.
“You have to stay strong and not cry anymore, okay? Without me by your side to protect you, you need to be a bit tougher. All those bad people are just paper tigers.”4
In an instant, time seemed to rewind to the night after the college entrance exams when she said the same words, then kissed Yu Gui’s forehead under the streetlamp.
Yu Gui sniffled, “Mm! I’ll work hard and make money! I’ll bring you over as soon as possible!”
“Excuse me… where is the emergency department?” A middle-aged woman wearing a faded gray nylon jacket walked in, looking travel-worn. She was holding two children by the hand, with another one strapped to her back with a piece of rope. They all had dirty, rosy faces and wide, dark eyes, looking around innocently and bewilderedly at their surroundings.
Hao Renjie didn’t even look up, “Go straight and turn right. Wait a moment,” he suddenly realized something and stood up abruptly.
“Are you… Wang Youshi’s family?”
“Yes, yes, I am,” the woman quickly pulled the children closer, her face full of hope. “Doctor, how is my husband doing?”
Hao Renjie knocked on the door, “Wang Youshi, your wife is here to see you.”
Wang Youshi quickly sat up in bed, but his sudden movement caused the IV needle to come out of his hand. Yu Gui immediately pressed down on his hand to stop the bleeding, and swiftly took a new needle from the medical cart to replace it.
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“Why did you come? I told you I’m…” While speaking, Wang Youshi suddenly felt a sharp pain in his liver area, clutching his side as his face turned pale.
Yu Gui became anxious, “Are you okay? Where do you feel uncomfortable? I… I’ll go get Dr. Lu…”
“No… it’s nothing…” Wang Youshi endured the pain and pulled each of his three children closer to look at them. The room was small, so his wife could only stand awkwardly. Yu Gui noticed her slightly swollen belly and quickly moved a chair from the triage desk for her to sit on.
The woman tried to decline, but instead, she grasped Yu Gui’s hand, “Doctor, doctor, you’re a good person. Please, tell me what exactly is wrong with him.”
“This…” Yu Gui looked at Wang Youshi.
“You wretched woman, shut up!” Unexpectedly, he suddenly flew into a rage, slapping the bed and shouting, “Are you hoping I die soon so you can remarry with the kids?”
The children were too scared to speak, and Yu Gui could only look to Hao Renjie for help.
Hao Renjie shrugged and mouthed, “Don’t look at me, I can’t help either.”
Patients with liver disease should avoid anger and agitation. After slapping the bed, Wang Youshi was wracked with pain, his forehead dripping with large beads of sweat. He gasped for air, his face turning a bluish-purple.
Wang Youshi’s wife patted his back, too busy to respond to his outburst, “Doctor, doctor, what should we do…”
Yu Gui became increasingly anxious, her forehead sweating even more than Wang Youshi’s.
“What… what medication should I use…” She held the syringe, flustered like an ant on a hot pan.
“You’re asking me? I’m not a doctor,” Hao Renjie was also baffled, “How did you even graduate from medical school?”
“I… I…” Yu Gui stammered, “Technically… I… I haven’t finished my residency training… I’m… I’m not fully graduated yet…”
Hao Renjie was exasperated, “Well, at this rate, I don’t think you’ll ever graduate.”
(LP: Well, with no one guiding her, how could she?? “( – ⌓ – ))
As luck would have it, Lu Qingshi happened to be making her rounds and quickly approached the doorway. She pressed her stethoscope to Wang Youshi’s chest and instructed the flustered Yu Gui.
“One dose of Dolantin, intramuscular push.”5
“Oh, oh, okay!” Yu Gui breathed a sigh of relief. She hurriedly retrieved the Dolantin from the medical cart, disinfected the skin with iodine, and carefully inserted the sharp needle into Wang Youshi’s vein. Fortunately, this time there were no mistakes.
The painkiller quickly took effect, and the accompanying sedative component soon put him to sleep. Wang Youshi’s wife stood in the hallway, waiting for Lu Qingshi to come out.
“Doctor, doctor, please, be kind and tell me what exactly is wrong with my husband!”
Lu Qingshi removed her mask and looked at her quietly, her expression calm and indifferent, neither sad nor happy, as she delivered the most devastating news.
“Late-stage liver cancer.”
Wang Youshi’s wife collapsed to the ground. She had no education and no knowledge of what liver cancer specifically entailed; she only knew that in their village, anyone who had cancer would not live much longer.
“He has decided to forego treatment, so there is nothing more we can do. Please discuss among yourselves when you want to discharge him, and settle the remaining fees.”
The woman sat on the ground, silently shedding tears. As Lu Qingshi turned to leave, she suddenly crawled over on her knees and grabbed the hem of her coat.
“Doctor… doctor… please don’t give up on the treatment… the child… the child can’t be without a father… money… I have money…” she said, pulling out a neatly wrapped bundle of three thousand yuan from her pocket, a mix of red bills and small change, and tried to stuff it into Lu Qingshi’s hands.
“Doctor… doctor, please take this first… if it’s not enough, we’ll find a way to get more… please, I beg you, don’t give up on the treatment… the child can’t be without a father!”
But the person she was holding onto was unmoved, completely expressionless. Yu Gui even suspected that Lu Qingshi’s face was paralyzed, showing nothing but a blank expression.
Unable to bear it any longer, Yu Gui helped the woman onto a bench and handed her a tissue from her pocket. When she turned back around, Lu Qingshi was already gone.
During dinner, Yu Gui specially bought two extra boxed meals and brought them to the ward. The family of four gathered around Wang Youshi’s bed, talking and laughing. Their eldest daughter, already ten years old and understanding a bit more, was reciting a newly learned Tang poem from school to him. Despite his emaciated appearance from the illness, a smile appeared on Wang Youshi’s face.]
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His wife stood by the bed holding their youngest daughter. Wang Youshi patted the bed and, this time, didn’t yell: “Come, come sit down, let me feel your belly.”
In front of everyone, the woman felt a bit embarrassed. “No… no, it’s okay… what are you doing…”
Yu Gui quietly placed the boxed meals at the door and turned to leave.
Perhaps this family had once favored boys over girls, but hadn’t fate already given them the greatest punishment?
At some point, it began to rain lightly outside. The shadows of the trees swayed as Yu Gui lay down, enjoying the cool breeze while eating her boxed meal and browsing the internet for information.
Hao Renjie walked past her and glanced at the screen: “Let me tell you, with your third-year medical school level, you can’t handle this surgery.”
Yu Gui puffed up her cheeks in defiance, “Who says I…” but her voice trailed off halfway. Someone who couldn’t even use painkillers properly didn’t have much confidence to boast.
Hao Renjie clicked his tongue and, with a flamboyant gesture, leaned in to look at her computer: “If you have this much free time, why not go ask Sister Lu for help? After all, the paper you’re reading now was written by her when she was still in school.”
The title in bold Song font stood out: “Specific Surgical Procedures and Precautions for Hepatectomy6 in the Treatment of Hilar Cholangiocarcinoma7.”
She quickly scrolled down to see the author:
Peking Union Medical College, Lu Qingshi.
Yu Gui’s face looked utterly dejected. Hao Renjie, swaying his well-shaped hips, walked away but couldn’t resist adding a final jab: “But I think asking Sister Lu might still be a waste of time. Instead of messing around, you’d be better off writing a few more patient records.”
Footnotes
- Neonatal intensive care unit (NICU): A specialized unit for the care of ill or premature newborn infants.
- Norwood procedure: A complex surgical procedure typically performed in three stages to treat hypoplastic left heart syndrome, a congenital heart defect.
- Hypoplastic Left Heart Syndrome (HLHS): A severe congenital heart defect where the left side of the heart is underdeveloped, requiring complex medical interventions.
- Paper tigers: A Chinese idiom meaning something that seems threatening but is actually harmless.
- Dolantin: A powerful painkiller (also known as Pethidine or Meperidine) used to quickly relieve severe pain.
- Hepatectomy: Surgery to remove all or part of the liver.
- Hilar Cholangiocarcinoma: A type of bile duct cancer that occurs in the bile ducts that lead out of the liver (hepatic ducts) and join with the gallbladder. Hilar cholangiocarcinomas are also known as Klatskin tumors.