godfather of surgery

Chapter 1291 Inclusive Plan
"Is the immune response under control?" Yang Ping asked.

"The corticosteroid dosage has been reduced to a maintenance dose, and the body temperature has stabilized below 37.8 degrees Celsius," Song Ziming reported. "However, the electroencephalogram (EEG) shows abnormal discharges in localized brain tissue."

“Continue to use anticonvulsants to prevent local irritation caused by tumor necrosis.” Yang Ping’s finger swept across the virtual image, zooming in on the tumor area.

In the observation room, Dr. Johannesson had been sleeping only four hours a day for the past three days. His notebook was filled with observation records and technical questions, and he cherished this learning opportunity.

“Professor Yang,” Johannesson asked through the internal communication system, “we found that the immune side effects were significantly reduced in the second treatment. Was this intentionally designed, or is it a natural process?”

Yang Ping pondered for a moment: "Your observation is very detailed. This is both a biological reality and a design consideration. We use genes carried by viral vectors to indeed set up a program for the reduction of immune response. This way, even when encountering a completely new individual, it will only cause a strong immune response during the first treatment. Starting from the second treatment, it will self-adjust. For the population, that is, the first batch of patients treated will have a strong immune response, and then it will gradually reduce the side effects while ensuring the treatment effect."

"So this is actually part of the security mechanism?"

"Yes, this is the fundamental technology that allows us to apply it on a large scale. Without this technology, it could easily lead to disastrous consequences."

Johannesson quickly took notes, inwardly marveling at the complexity of K-therapy technology. In just a few weeks of observation, he had witnessed technical details surpassing all the gene therapy research he had encountered in the United States over the past five years. The technological gap wasn't minor; it represented a complete leap forward in both the underlying concept and the implementation path.

The genetic and immunological knowledge involved in the mechanism of gradually reducing the immune response that Professor Yang just mentioned is very cutting-edge and complex.

In the next ward, Rigoyan was experiencing the easiest period of his treatment so far. His ventilator had been switched to intermittent support mode, and he was able to breathe independently for several hours. Rolf sat by the bed, showing him the company's latest reports on a tablet.

“The stock price has rebounded by 42%,” Rolf said softly. “Wall Street analysts are starting to adjust their expectations, and their confidence in many of BG Group’s subsidiaries is recovering.”

Li Gaoyang blinked, indicating that he was listening.

“But the pressure has also increased,” Rolf continued. “The White House wants us to share more technical details, and the FDA has hinted that if the data is sufficient, it may initiate the formal approval process within three months. Delegations from Europe and Japan have been contacting us, hoping to exchange experiences…”

He stopped and looked at Li Gaoyang: "Everyone is watching you, watching the outcome of this treatment."

Li Gaoyang slowly raised his still-functioning left hand and, with trembling fingers, wrote a few words on the tablet's memo page: "Professor Yang... what did you say?"

Rolf read it aloud and replied, "Professor Yang said that a comprehensive evaluation will be needed after the third phase. If the tumor residue is less than 10%, it will be considered a clinical success. However, to achieve complete remission, maintenance therapy may be necessary."

Li Gaoyang was silent for a while, then wrote: "Pain... is worth it."

"What did you say?" Rolf didn't understand.

Li Gaoyang closed his eyes, gathering his strength, then reopened them, his fingers moving slowly: "This kind of pain... if it can spare more people... from experiencing it, then it's worth it."

Rolf froze, then his eyes suddenly welled up with tears. He had followed Rikoyan for over twenty years, witnessing the man's ruthlessness, cunning, and merciless battles in the business world. But at this moment, on the verge of life and death, Rikoyan uttered the word "worth it" for the first time, and for "more people."

“I will pass that on to Professor Yang.” Rolf’s voice was choked with emotion.

Li Gaoyang nodded, then turned his gaze to the window. Having experienced life and death, he seemed to have changed completely.

……

While Li Gaoyang was battling his illness, in a penthouse suite of a five-star hotel in the provincial capital of Nandu, representatives of the six giants were holding an informal, secret meeting.

There were no meeting minutes, no lawyers present, and even waiters were forbidden from entering. There were only six people in the room—the chief negotiators from each company.

“Let’s be frank,” Schneider spoke first. “We can’t keep going our separate ways like this. Huang Jiacai is clearly playing a divide-and-conquer strategy, making us bid against each other so he can reap the benefits.”

Thompson from the US sneered: "Realizing now? I said a month ago that the united front cannot be broken. But who was it that said 'differentiated competition is more advantageous' back then?"

“The situation was different back then,” Sato from Japan said calmly. “Back then, we had doubts about the authenticity and feasibility of the technology. Now, Rigaoyang’s treatment data is there for all to see; the technology is real, and the efficacy is real. This means that whoever secures the cooperation agreement first will gain a head start in the cancer treatment market over the next decade.”

"So we should reunite?" asked DuPont of France.

“It’s not a formal alliance, but a strategic coordination.” Schneider pulled up an analysis chart on his tablet. “Look here, Ruixing’s partner evaluation criteria: technology transfer capability accounts for 30%, production quality control accounts for 25%, market coverage capability accounts for 20%, pricing and accessibility commitment accounts for 15%, and ethical and social responsibility record accounts for 10%.”

He looked around: "Our six companies each have their own strengths."

"You mean...we should allocate priorities internally, highlight our respective strengths, and then support each other?" Sato understood.

“Exactly.” Schneider nodded. “For example, if Sato can promise to reduce production costs by 30% when he applies, we will publicly support the plan; if we promise to establish six regional training centers in Europe, you will express your willingness to adopt a unified training standard. In this way, it will be difficult for Ruixing to use one company to pressure another.”

“But that still makes us competitors.” Thompson frowned.

“While we are eligible for the final cooperation, we can be allies when it comes to creating the cooperation framework,” Schneider said. “More importantly, we need to work together to put pressure on Ruixing to demand more reasonable commercial terms. An inclusive framework is acceptable, but licensing fee ratios, data ownership, regional exclusivity periods… these all require room for negotiation. Gentlemen, we are determined to secure cooperation, but we will strive for as many favorable terms as possible.” A moment of silence fell over the room as the representatives considered their options.

“I agree with this approach,” the British representative said for the first time. “But we need a more specific agreement. For example, if a company is authorized to operate in a certain region, it should provide necessary support channels when other companies enter adjacent markets. Or, for instance, we should establish a sharing mechanism for technical training and quality control standards.”

“This requires legal documentation,” another representative cautioned.

“Let’s reach a gentleman’s agreement first, and then refine the details once the eligibility for cooperation is confirmed,” Schneider said. “What we lack most right now is time. Ruixing will begin accepting formal applications next week, and the evaluation period is only three months. We must prove three things to Huang Jiacai within these three months: First, cooperating with us is the most efficient option; second, if we unite, we also have the ability to cause trouble for Ruixing; third, choosing to cooperate with those small and medium-sized enterprises or letting the giants under BG monopolize the business are not the best options.”

"Create trouble?" DuPont raised an eyebrow.

Schneider lowered his voice: "I've received information that there are voices within the European Medicines Agency dissatisfied with the 'data sharing' clause of the Affordable Care Framework, believing that it could lead to European patient data flowing to China. If we push for a related hearing in the European Parliament..."

“This is too dangerous,” one representative immediately objected. “It would escalate business negotiations into a geopolitical confrontation, which could backfire.”

“It’s just a backup plan,” Schneider said. “The premise is that Huang Jiacai doesn’t give us any reasonable business space at all. But now it seems that he is more shrewd and stubborn than we thought. He is an extremely clever opponent.”

Thompson suddenly laughed: "Gentlemen, haven't we overlooked the simplest question—why should we accept this framework? Why can't we jointly develop alternative technologies?"

The room fell silent again, a thought that everyone had on their minds, but no one dared to voice it aloud again.

“What I mean is that we can use the development of alternatives as a bargaining chip, rather than actually doing it. Of course, cooperation is just a temporary measure now, and one day we will develop alternatives,” Thompson said confidently.

“You have a good idea, but don’t forget, they know more about alternatives than we do. There’s simply not enough time,” Dr. Morrow finally spoke, the scientist representative having remained silent until now. “I consulted the company’s top gene therapy team. Their assessment is that even if we start now and invest five billion dollars, it will take at least five years to replicate the technology of K therapy. And to verify its safety and efficacy, complete clinical trials, and obtain approval, that will take another five years.”

She looked around: "What will the market be like in ten years? How many generations of technology will Ruixing have iterated to? Can we afford to wait? Huang Jiacai knows better than us. Forgive me for speaking frankly, although his educational background seems terrible, he understands technology better than you. Based on this, we don't really have much room for maneuver in this negotiation. You can't beat him."

The harsh reality silenced everyone. This is the most terrifying aspect of technological gaps—it's not simply a product advantage, but a lead in the entire technological roadmap. The time required to catch up is enough for the leader to build virtually insurmountable barriers.

“Let’s do it this way then,” Schneider finally said. “We’ll coordinate our positions during the application phase to try and get the best terms. But we’ll each keep our applications independent, and the final qualification for cooperation will depend on our own abilities. At the same time, we’ll start preliminary research on alternative technologies, even if it’s just as a bargaining chip.”

No vote, no signature, but a consensus had been reached. Six hands reached out one after another to the center of the round table, overlapping each other—a brief and fragile alliance, re-formed in the face of shared interests.

Unbeknownst to them, the signal jammer in the hotel suite failed to completely block the latest generation of eavesdropping devices from the Ruixing security team. Three kilometers away, in an office building, Huang Jiacai's assistant removed his noise-canceling headphones and quickly summarized the information he had just intercepted.

Five minutes later, the summary appeared in Huang Jiacai's encrypted email.

On the twentieth day of Rikoyan's treatment, Sanbo Hospital received its first general patient under the inclusive medical care framework.

She's not a tycoon, not a celebrity, and doesn't even have commercial insurance. Her name is Li Xiaoyun, a 42-year-old primary school teacher and mother of two. Three months ago, she was diagnosed with glioblastoma, grade IV, and doctors gave her no more than six months to live.

She qualified through the newly launched "Global K-Therapy Patient Application Platform," which prioritizes patients in her home country before gradually expanding to the rest of the world.

This platform is designed according to an inclusive framework and is completely transparent: patients submit their medical records, the system automatically assesses the severity of their condition and the necessity of treatment, and then ranks them according to their waiting time. There is no human intervention or ability-to-pay verification—because, according to the framework, patients who cannot afford to pay will receive assistance from the Global Treatment Fund.

Li Xiaoyun's husband, Wang Jianjun, an ordinary engineer, squatted in the hospital corridor and cried for ten minutes when he learned that his wife had been eligible for treatment. They had sold their house in their hometown, borrowed money from all their relatives and friends, and were originally prepared to give up and accept the cruel prediction of their life expectancy.

They have now been placed in a regular ward at the Sanbo Research Institute, and Yang Ping is personally making rounds.

“Teacher Li, this is Yang Ping.” He said gently, “We will begin the first phase of treatment this afternoon. The whole process will take about six weeks, during which you will need to be hospitalized. Please feel free to ask any questions you may have.”

Li Xiaoyun was very weak, but her eyes were bright: "Professor Yang... I heard that this treatment is very expensive, and this new therapy cannot be recognized by insurance companies for the time being because it is currently only in the clinical trial stage."

"Under the Universal Benefit framework, your treatment costs will be calculated as a percentage of your family's annual income. Your husband's income verification shows that you will be responsible for 10% of the total cost, with the remainder covered by Medicare and the Global Treatment Fund."

"So... how much is it?"

Yang Ping glanced at the medical record: "Your total treatment cost is estimated at 800,000 RMB, and you will need to pay 80,000 RMB."

Wang Jianjun was stunned: "The treatment costs 800,000 yuan, and we only need to pay 80,000 yuan?"

"Yes, that's the point of the inclusive framework—to make technology accessible to those who truly need it, not just those who can afford the full price."

The couple looked at each other, and tears welled up again—this time, tears of hope.

Treatment began at 2 PM. Unlike Li Gaoyang's personalized approach, Li Xiaoyun used a standardized viral vector, reducing production costs by 70% and making it more accessible to everyone.

In the ward, Song Ziming and Xu Zhiliang were in charge of the entire treatment; they were already very skilled at it.