godfather of surgery

Chapter 1289 The First Volunteer

The delegation of the multinational pharmaceutical giants alliance has been staying at a hotel in the provincial capital of Nandu for several days.

"He's insane!" Thompson was the first to speak. "Complete control of the core technology? Publicly releasing all pricing data? This completely defies business logic!"

“But he’s telling the truth,” Kenichi Sato said calmly. “If we don’t cooperate, we could indeed be excluded from the next generation of treatment systems.”

“We can jointly develop alternative technologies to address this,” another representative suggested.

"How long will it take? Five years? Ten years?" Dr. Isabelle Morrow, a representative of a European pharmaceutical company, shook her head. "I have carefully studied Yang Ping's paper. Their technical approach is completely different from ours. It is a true innovation, and it is almost impossible to replicate it in a short period of time."

Schneider rubbed his temples: "The key question is whether we really need to maintain the united front? Huang Jiacai is right. Under the Inclusive Finance framework, we are actually competing to become partners, not jointly controlling each other. If the six of us continue to be tied together, he may choose to cooperate with other small and medium-sized companies, and then we will suffer greater losses. In any case, we must secure our entry ticket to this future market."

"So your suggestion is... for each side to negotiate?" DuPont asked.

“At the very least, we need to maintain flexibility,” Schneider said. “We can reach a gentleman’s agreement: to stay on the core terms, such as the lower limit of pricing and regional divisions, but to be flexible in the specific ways we work together.”

“I agree,” Sato immediately stated. “We are willing to offer more competitive solutions in terms of process optimization and production in Asia.”

“But that would mean we’d be bidding against each other, and ultimately Ruixing would be the one to benefit,” Thompson objected.

“Or we can continue to exert joint pressure,” Dr. Morrow suggested, “but with a different objective: not to control the technology, but to secure more favorable licensing terms. For example, extending the licensing period, reducing licensing fees, and having more say in the decision-making process.”

Ultimately, the six giants reached an internal memorandum: to maintain an image of "consensus" externally, but in practice, each company would be allowed to conduct differentiated negotiations with Ruixing based on its own strengths. At the same time, they would jointly pressure Ruixing to make "reasonable adjustments" to certain terms of the inclusive finance framework.

Negotiations have resumed.

“Mr. Huang,” the Schneider representative said, “After discussion, we are willing to explore cooperation within the framework of universal healthcare. However, there are several issues that need to be addressed: First, the authorization period should be no less than 15 years; second, partners should enjoy a certain period of market protection in their respective regions; third, the pricing mechanism needs more flexibility, especially for countries with different healthcare systems; and fourth, we hope to establish a joint steering committee in which partners have substantial advisory power.”

After listening, Huang Jiacai nodded slightly: "We can discuss these issues. I also need to reiterate our core principles: control over core technologies, global pricing transparency, and non-exclusivity. As long as these three core principles are followed, Ruixing is willing to engage in constructive dialogue with you."

After exchanging glances, Schneider said, "Alright, let's continue discussing some details of the collaboration."

Two hours later, Huang Jiacai glanced at the time: "We've already discussed a lot today, so I suggest we continue tomorrow. We can continue to discuss the specific terms one by one. Also, tomorrow afternoon, members of Professor Yang Ping's team will come from the lab to have technical exchanges with you all."

This news was a great relief to the delegates. Meeting with Professor Yang Ping's team members meant they could gain a more direct understanding of the technical details, and it also meant that Ruixing was indeed seriously considering cooperation.

The meeting concluded and the delegation departed.

Huang Jiacai remained alone in the conference room when his assistant entered.

"Mr. Huang, a reporter from the Wall Street Journal would like to interview us about this negotiation."

"No comment for now," Huang Jiacai said.

……

Washington, East Wing of the White House.

Inside the Oval Office, a life-or-death meeting is underway. This is not a regular national security meeting, but it could potentially impact America's future standing in the field of biotechnology.

“Mr. President, here are the data.” Dr. Alan Wilson, Director of the National Institutes of Health (NIH), placed a thick report on the oak table. “The clinical trial data provided by the Tri-Bio Research Institute, after our most rigorous double-blind review, confirms an efficacy rate of 92%, while the existing standard therapy averages only 19%. The serious adverse reaction rate is 1.2%, far below the 5% threshold required for routine FDA approval.”

The president flipped through the report, his brow furrowed. A lawyer by training, he possessed an instinctive caution when it came to scientific data, but the charts and statistical significance markers (p<0.001) in the report didn't lie.

"What about security?" the president asked, looking up. "Especially technology transfer and long-term dependence."

“That’s the crux of the matter,” the National Security Advisor continued. “The Chinese made it clear in the agreement that core intellectual property rights would not be transferred, the production process would not be transferred, and treatment could only be conducted in designated centers. This means that even if we approve its use, control of the technology will remain in the hands of the Chinese.”

The president put down the report, leaned back, and remained silent, a brief silence falling over the office.

"How is Rikoyan's condition?" the president suddenly asked.

The Secretary of Health and Human Services replied, "The intracranial tumor continues to grow. Dr. Johannesson predicts that his life expectancy is in months. We have already missed the opportunity for surgery, and if we delay any longer, we will miss the best time for K therapy."

“If he has some kind of problem, and we refuse a treatment that could save him because of procedural reasons,” the president said slowly, “what will the public say? Will the New York Times headline be ‘Bureaucratic Bureaucracy Kills American Entrepreneur’?”

No one answered, but everyone knew the answer.

"What about the political implications?" the president asked his chief of staff.

"The Senate Health Committee has received over 50,000 letters from voters demanding expedited approval. Twenty-three patient advocacy groups will rally tomorrow in front of the Washington Monument. On Wall Street... BG Group's stock has fallen 18% in the past two weeks, but interestingly, analysts predict it will surge by more than 40% if news of FDA approval breaks."

The president stood up, walked to the window, and in the distance, the Washington Monument stood tall in the sunlight.

“Allen,” he said without turning around, “from a professional standpoint, do you think this technology is worth the risk?”

Dr. Wilson took a deep breath: “Mr. President, I have been engaged in oncology research for forty years, and this is the most disruptive advance I have ever seen. It could open up a completely new treatment paradigm. If we refuse, Europe, Japan, and even Singapore will be scrambling to cooperate, and then we will truly fall behind.”

“Katherine,” the president turned to the National Security Advisor, “what is the worst-case scenario if we approve it?” “Technology dependence, data security risks, and the potential to open a door for more Chinese biotechnology to enter the U.S. market in a similar manner.”

The president nodded and returned to his desk. His fingers tapped lightly on the surface.

“Okay,” he finally began, “Issue a special presidential authorization to approve ‘emergency humanitarian clinical trials’ of K therapy in the United States, initially allowing treatment of no more than ten critically ill patients. But with the following conditions: First, all treatment data must be shared with the National Institutes of Health in real time; second, treatment must be conducted at Johns Hopkins Hospital, with the U.S. medical team involved throughout; third, the authorization will be terminated immediately in the event of a serious adverse event; fourth…” He paused, “This matter must be handled discreetly, the document should be marked ‘national security exemption,’ and it will not enter the regular approval and public disclosure process.”

"Will Rikoyan be the first?" the chief of staff asked.

"He fought for it himself, didn't he?" the president said meaningfully. "Tell the FDA to issue the documents by 5 p.m. today. But remember, this is an exception, not a precedent."

When the message reached New York-Presbyterian Hospital via an encrypted line, Rikoyan was already very weak. Rolf leaned close to his ear and said, word by word, "It's approved. You will become the first patient in the United States to receive K therapy."

Li Gaoyang's eyes opened slightly, a glimmer of light flashing in his cloudy pupils. With all his might, in an almost inaudible voice, he said, "Go to China...the sooner the better..."

……

Upon receiving notification from the US side, Huang Jiacai, at the headquarters of Ruixing, immediately convened an emergency strategic meeting.

“Li Gaoyang is indeed incredibly powerful! The president has granted special authorization, with a limit of ten people, and four additional conditions.” Huang Jiacai projected the document summary onto the screen. “What does this mean?”

The legal counsel spoke first: "This means that the US did not go through the regular approval process, but instead used its administrative privileges to open a small loophole. This is both an acknowledgment of the technology and a restriction on us—they want to acquire data and learn the technology, but they don't want to officially open up the market."

"Is Professor Yang ready?" Huang Jiacai asked.

“The technology at the Sanbo Research Institute is mature and we can begin K treatment at any time,” Song Ziming replied, representing Yang Ping at the meeting. “However, we insist on two points: first, the treatment must be conducted at our institute; second, we refuse any participation from American personnel.”

"The US will not agree to send patients to China," some people have expressed their concerns.

“Then there’s nothing to discuss.” Song Ziming said firmly. “K therapy is not a simple drug injection, but a complex treatment plan that includes the construction of a targeted viral vector, individualized dosage calculation, and post-treatment monitoring. Any mistake in any of these steps could be fatal. Currently, only our research institute has the complete capability to execute it.”

“Rigoyan is a special American on this point regarding the involvement of American medical personnel, and they are unlikely to back down,” the person who had just raised the concerns continued.

Song Ziming answered clearly: "This is not a negotiation, it's a request, and we're not sure if we'll accept it. Tell them that it's impossible to involve American medical personnel; they don't have the technical qualifications to participate in K therapy."

“Li Gaoyang’s treatment data can be shared with them,” Song Ziming added.

Huang Jiacai paused for a moment, then said, "Reply to the US: The treatment is still being conducted at the Sanbo Institute in China, and US medical personnel are not allowed to participate. All data can be shared in real time. In exchange, the US must publicly commit to initiating the formal approval process for K therapy after the completion of the first phase of clinical trials."

"Is this enough?" someone asked.

“For Rikoyan, that’s enough, and for us, that’s enough too.” Huang Jiacai stood up. “For him, every minute was a race against death. For the US authorities, they needed this case, which demonstrated humanitarianism and provided them with crucial technical data. We also gained their approval of the technology, which we can then use to promote it to the world.”

He turned to his assistant: “Inform Rolf of BG Group that if they agree to our terms, they can send Rikoyan over immediately.”

The command was given, and the machine started operating.

Forty-eight hours later, a Gulfstream G650 medical evacuation plane landed at Nandu International Airport. The aircraft had been specially modified and equipped with a complete intensive care unit. Li Gaoyang was under the monitoring of medical personnel and various monitoring instruments throughout the flight.

Beside the airport runway, the mobile ICU vehicle from Sanbo Hospital was already on standby. When the hatch opened, Rolf was the first to step down the stairs, his face etched with exhaustion and anxiety. For the past seventy-two hours, he had barely slept, coordinating a complex transfer that spanned half the globe.

"Mr. Huang, Dr. Song." Rolf shook hands with the welcoming Chinese team, his palms sweaty. "We meet again. Thank you for everything you've done. Mr. Rigoyan's condition... is very bad."

Following closely behind Rolf was Johannesson, who held Song Ziming's hand without saying a word.

Song Ziming nodded, skipped the pleasantries, and headed straight for the ambulance: "Let's go to the hospital first, and check the data on the way."

The convoy sped towards the Sanbo Research Institute. Inside the car, Song Ziming rapidly browsed Li Gaoyang's latest video data and biochemical indicators on a tablet, his brows furrowing deeper and deeper.

“The tumor has increased in size by 27% since two weeks ago,” he told Johannesson, who was in the same car. “The invasion is expanding, and there is significant hydrocephalus. We need to perform external ventricular drainage to reduce intracranial pressure first; otherwise, it could lead to brain herniation before treatment even begins.”

The graduate student next to him quickly took notes.

"Observe for 24 hours after drainage. If the vital signs are stable, then start the first stage of K therapy."

Sitting opposite him, Rolf asked nervously, "How risky is it?"

Yang Ping raised his head, his gaze calm: "Any treatment carries risks, but for Mr. Li Gaoyang's current condition, the risk of not treating him is 100% death, while the risk of treatment... our assessment is a 50% success rate."

"Only 50%?" Rolf's voice trembled.

“This is still an optimistic estimate,” Song Ziming said. “If it were three months earlier, the success rate could be over 80%. But now, the tumor burden is too great and the patient’s overall condition is too poor, but we will still do our best.”

Rolf closed his eyes and took a deep breath: "He knows the odds himself, and he said he has to try no matter what."

“There are some things… I know I shouldn’t say them in this setting, but on behalf of Mr. Rigoyan, I still want to say… I’m sorry, and thank you for accepting us,” Rolf said gratefully.

(End of this chapter)