top student at medical school

Friday, June 20th, heavy rain poured down.

At nine o'clock in the morning, in the trauma surgeon's office of the new campus of Zhongnan Hospital, Fang Ziye stared absently at the raindrops hanging on the window.

For example, under the filamentous column, inconspicuous marks are left on the outside of the glass.

Beside Fang Ziye, Associate Professor Tang Yi had a serious expression and hesitated several times before speaking.

Qin Geluo and Li Nuo kept flipping through a medical record book, as if trying to find important clues in it.

Feng Junfeng, Tian Yao, and others changed medical orders and wrote medical records by typing on the keyboard. No one spoke, as if the office had been muted.

After what seemed like an eternity, Fang Ziye finally took a deep, calm breath: "Qingyuan, how many spinal cord injury cases have we treated so far?"

“Master, including the surgery we performed yesterday, we have performed a total of forty-seven surgeries.”

"So far, only the patient in bed 15, who was operated on last Friday, has shown no improvement in symptoms after the surgery. The recovery of the remaining 46 patients has far exceeded expectations," Hu Qingyuan reported the relevant data with great precision.

The reason everyone was so worried was that the second spinal cord injury acupuncture electrode microcurrent stimulation performed last Friday had been completely ineffective.

To date, the patient's functions and performance are basically the same as before the surgery.

A full week has passed, and based on the available data, it can be concluded that the surgery was a failure.

At that time, this patient was supposed to be the forty-first spinal cord injury surgery.

"Based on current statistics, the failure rate is 1 in 40, or 2.5%!"

"The success rate of my limb-sparing surgeries on severe injuries is 99.5%!"

"Forget it, I won't dwell on it!"

Fang Ziye stood up: "Professor Tang, why don't you take your people downstairs and prepare to start the procedure? I'll go and explain it to the patient and their family in detail."

Upon hearing this, Tang Yi immediately replied, "Ziye, let Li Nuo and Qin Geluo take their men down first. I'll go with you."

Then, Tang Yi pushed up his glasses and said, "Actually, Ziye, our data is already incredible!"

"The Great Dao is fifty, and the Heavenly Cycle is forty-nine. Under no circumstances can it be one hundred percent, let alone a disease like a complete paralysis spinal cord injury..."

"We may not even have a basic understanding of spinal cord injury or its classification yet."

"But the current diagnostic results and treatment effects are already at least ten years ahead of the forefront of modern medicine!"

"Even after the technique is perfected, it may take other teaching hospitals five to ten years of preparation to learn it!" Tang Yi comforted her.

“Ziye, if you can’t accept this result, I can go and explain it to the patient.”

Humans are just humans, not gods.

Surgery is just surgery, not a miracle.

Since surgery is involved, there are inherent probabilities, such as the one-in-a-million chance of sudden death during a minor surgery, the failure rate, and the probability that a subtype of the disease cannot be clearly diagnosed.

"No need, Professor Tang, I'm not a perfectionist! I'm just thinking about what I didn't do well, but I can't seem to figure out what I did wrong!" Fang Ziye said.

Tang Yi nodded and pointed at Hu Qingyuan: "Hu Qingyuan has full video recordings of all the surgeries we've performed."

"We also reviewed that at that time you were not drinking, not tired, and did not make any operational mistakes, so you were in your peak condition."

"We were so confident on stage, feeling like we were basking in a spring breeze."

"But perhaps our diagnostic classification of spinal cord injury is not systematic enough, so there is an inherent subtype of spinal cord injury that cannot be treated with microcurrent stimulation!" Tang said.

We can only speculate at this point!

How to classify them? I don't know.

We still don't know which subtype of treatment is ineffective!
This is the fact.

The more humanity explores, the more ignorance it will encounter.

……

"Qingyuan, come with us. Everyone else, go to the operating room first." Fang Ziye did not refuse Tang Yi's offer.

Currently, within his group, he and Tang Yi hold the highest professional titles, both being associate chief physicians and associate professors, which is more convincing than Li Nuo's single title of associate chief physician.

Hu Qingyuan strode out and called over the family member of the patient in bed 15.

15床病人是六月十号住院的，6月13日就做了手术，目前6月20日！
The difficulty in spinal cord injury surgery lies not in the surgical procedure or the length of time it takes, but in the fact that the postoperative observation period and the observation period for the therapeutic effect must be long enough.

It would take Fang Ziye at least two weeks to discharge the patient.

"Professor Fang, Professor Tang, what's wrong?" A middle-aged woman walked in.

The patient's family members are the patient's wife and father. The patient's children are in school, while the mother stays at home to take care of the children.

"You must be Fujian's wife? Please have a seat." Fang Ziye looked at the newcomer and said with a smile.

"You sit, I'll stand... I can't answer that." The patient's father told his daughter-in-law to sit.

He just has more strength and a bit more patience, but when it comes to important matters, he may not know as much as his daughter-in-law.

Hu Qingyuan then brought over another chair for the patient's father to sit down as well.

"Professor Fang, my husband... Could it be... that the surgery really failed?" The patient's wife was nearly forty years old, but she was well-maintained.

Her every gesture revealed her considerable knowledge. At this moment, she was merely flustered and did not reprimand her.

Fang Ziye nodded: "Hu Jian has been out of surgery for a week now, but there has been no improvement in his function. The surgical results are indeed very poor, almost non-existent."

"From the perspective of treatment effectiveness, the surgery was indeed a failure," Fang Ziye said.

"Why is this happening?" the elderly woman next to her asked, raising her voice.

Fang Ziye shook his head; "I don't know!"

"Don't know? If you don't know, why are you a doctor? Are you trying to rob and kill people?" The old man seemed to have found his home turf.

Hu Qingyuan immediately reassured him, "Uncle, don't panic. Shouting won't solve the problem!"

The old man said, "I don't want to yell, but please don't mess around. Get my son cured!"

"Now that you've caused problems, you want to apologize? Where were you before?"

"Why wouldn't you know?"

Hu Qingyuan asked, "Uncle, why is Hu Jian only coming to us for treatment now?"

Why didn't he have the surgery at another hospital?

"With so many top-tier hospitals in China and around the world, why didn't he go?"

"You're not going to answer?"

"Why wouldn't they know? Because nobody knows!"

"For this disease, with this current treatment, no one in the world besides my teacher knows how to perform this kind of surgery!"

“My master is just a human being, not a god. He can’t guarantee that he knows everything or that every surgery will be effective.”

"All he can guarantee is that he will do his best in every surgery!"

"It was made clear before we came that this surgery was only in the clinical trial phase."

Hu Qingyuan looked at the patient's wife: "Your father-in-law may not know, but you do, right? What is a clinical trial period?"

"Clinical surgeries, where the effectiveness and failure rate of treatment cannot be determined at the moment, are called clinical trials."

Whether or not you choose to participate in clinical trials is your own choice!!!

The old man asked, "So you mean that your doctors did nothing wrong, and my son's surgery didn't work because he was unlucky? It's all fate, and we brought it on ourselves?"

After listening, the middle-aged woman thought for a moment and replied, "Dad, why don't you go back first? I'll talk to Professor Fang."

"Why would I go back? I'm going to stay here and listen."

"I'd like to see how they try to justify this! Why is it only my son who's going to suffer?"

The middle-aged woman stood up and offered to help the old man: "Dad, you go back first. We'll talk later. I'll chat with Professor Fang and the others."

"I'm not going back," the old man said stubbornly.

"What will you do if you don't go back? There's no one who can treat Hu Jian's illness. Now that the surgery is ineffective, are you going to scold the doctor or get Hu Jian treated?"

"Besides Professor Fang and his team, who else can you find to solve this problem?"

"Which hospital haven't we visited?"

"Do you think this is just an argument? Whoever has more people wins? And what's the point of winning anyway?"

"My husband can just lie down at home and be fine?" "He's your son. You can't hurt him," the middle-aged woman said.

The old man panicked: "I didn't harm him, it was them..."

The old man hesitated, then said, "But you can't help Fujian! There's no one else who can help Fujian right now, so we have to ask for help, you know?"

"This is the way to solve the problem, not by arguing, and not by offending Professor Fang and the others."

"Would you like to go back?" the middle-aged woman asked, maintaining her composure.

The old man stood up, glanced at his daughter-in-law, and then looked at Fang Ziye and the others.
Finally, he turned and left the office.

Fang Ziye then said, "Madam, do you believe me? I have no grudge against your husband, and I would never deliberately target him."

"So, I did my best when I performed the surgery on your husband!!"

“I would gain nothing from harming him, whether financially, in terms of reputation, or otherwise.”

The middle-aged woman did not agree to Fang Ziye's words, but said, "Professor Fang, Professor Tang, I apologize to you on behalf of my father-in-law. He is just a countryman, not very knowledgeable, and has a bit of a temper. Moreover, he was worried and confused, so he spoke without thinking."

After the middle-aged woman finished speaking, she added, "Of course, Professor Fang, you and my husband have no grudges against each other."

"It seems that apart from my husband, the other patients in the department are recovering quite well after surgery. Our whole family is hoping that my husband can stand up like them."

“Including my son and my daughter, they video call us every night…”

The middle-aged woman was either in politics or business; she was very clever. Instead of arguing or confronting Fang Ziye, she played the emotional card.

If every now and then there's someone in the department whose treatment isn't effective, it can be attributed to whether the technique is not mature enough or whether the doctors have a bad attitude.

While the odds of it happening are odds, and she was certainly unlucky, she still wanted to find a solution.

Fang Ziye sighed softly: "I also hope that your husband's treatment will be very effective, so I won't have to worry so much."

“Actually, I’ve been thinking about your husband’s case since Wednesday, but unfortunately, I still haven’t figured out why.”

"You and your husband have been to many hospitals, so you should know about the condition of total paralysis caused by spinal cord injury. At present, it is basically impossible to treat."

The middle-aged woman said, "Professor Fang, you don't need to explain so much to me. Could you please give me your suggestions?"

“We inquired for a long time and waited in line for a long time before we found out that you could treat this disease.”

Even if the current treatment isn't effective, you should still be able to give us some suggestions!

"With your skill level, it's impossible that you would deliberately delay my husband's hospitalization because of these surgery and hospitalization fees. I'm absolutely certain of that..."

The middle-aged woman only wanted a solution and didn't care whether Fang Ziye and the others were at fault.

The person is not dead yet, and is not worse than before the surgery; it's just that this trial treatment failed.

This is the fixed result!

Fang Ziye said, "A couple of days ago, I was reflecting on whether we had done something wrong, and whether we could perform a second procedure to correct the operation."

"But after reviewing the recorded video, we found no problems, including the puncture site and the current flux of the microcurrent stimulation, all of which were standardized."

"Therefore, there is little point in performing another surgery."

"If I had to give you advice, you might not be willing to accept it."

The middle-aged woman said, "Professor Fang, please speak."

The middle-aged woman was very polite to Fang Ziye for two main reasons. One was that she only wanted a solution, and the other was that she knew very well that with her influence and background, she would be in trouble if she dared to delay Fang Ziye's clinical work.

They might face even bigger troubles than a failed surgery, troubles that would not only affect their husbands' lives, but could even affect the lives of their entire family.

She knew this before they came for their consultation.

"You can be discharged first. I'll remember your husband's condition. Once I find a solution and understand why, I'll let you know to come back for treatment..."

“I have confirmed your husband’s previous surgery multiple times, and there is absolutely no room for correction.”

Fang Ziye didn't explain things to the middle-aged woman in a very professional way, such as the classification of spinal cord injuries.

The cost of surgery during the clinical trial phase is very low because of funding subsidies; patients basically don't spend any money.

This stage is where patients risk their lives for better treatment outcomes, and researchers use funding to obtain data.

Even so, those who are now scrambling to get here are still people with some money and influence.

The middle-aged woman fell silent.

Fang Ziye's proposal was indeed, as he himself said, a bit too idealistic.

Fang Ziye continued, "Of course, you can also take your husband to other hospitals for treatment. If anyone says that my surgery was wrong, or that there was a mistake in the operation, or that it aggravated your husband's condition, I am willing to accept your reasonable requests."

The middle-aged woman said, "Professor Fang, please stop testing me."

“Actually, long before my husband started his surgery, before I was hospitalized, I asked around through various people.”

"Currently, even to be conservative, you are among the top three in the country in the treatment of spinal cord injuries, if not the best in the country."

"Nobody knows how the surgery is done, so how dare they say you're wrong?"

“I could find a few laymen to forcefully say that Professor Fang is wrong, but wouldn’t that mean my husband would lose the opportunity for further treatment?”

"He's really unlucky; he's actually at a crucial stage in his career..."

Fang Ziye replied, "Yes, I know."

"But given Hu Jian's current physical condition, he can forget about any career advancement. Even if the treatment is very effective, it's impossible for him to consider such a thing."

“In our department, even the patients with the best treatment outcomes cannot perform their daily work like normal people. All we can say is that they can free themselves up and go out for a walk.”

"Madam, this is the best suggestion I can think of, or you can proceed with other procedures!"

Fang Ziye would not voluntarily offer to pay compensation.

When signing informed consent forms for clinical trials and surgeries, everything is clearly written in black and white.

Fang Ziye did not violate the principle of non-harm.

The patient was already paralyzed in both lower limbs before being admitted to the hospital, and is currently in a state similar to before.

It's no longer possible to "paralyze" itself.

If you're wrong, you should admit it; if you're not wrong, you can't just kneel down and admit it.

Fang Ziye also does not want to see cases of ineffective surgery, but this is an objective reality of the issue.

The middle-aged woman then asked, "Professor Fang, do you know when my husband can receive treatment again?"

Fang Ziye continued to shake his head: "I'm sorry, elder sister, I still don't know. Everything is unknown."

I can't give you a specific timeframe.

"This isn't about efficiency; it's about turning ignorance into knowledge, into confidence. No one can answer that question for you!"

……

After Fang Ziye and Tang Yi left the ward together, they heard whispers behind them.

"What's wrong with Professor Fang? Is it because the family of patient 15 is giving him trouble? I heard that patient 15's treatment isn't going very well."

"I don't know, I'll go ask around later."

“All surgeries carry risks. There’s no need to cause trouble for Professor Fang. Just during his hospital stay, so many people have come and gone…”

"Those who are not in a position should not meddle in its affairs!"

"Since we're not family, perhaps we can't feel the pain that family members feel, so there's no need to be too arrogant."

“We are just outsiders, they are family. Let’s wait and see what the family does. As long as it’s not too excessive, they still need an outlet for their emotions.”

"After all, the higher the expectations, the greater the disappointment!"

"..."

As Tang Yi went downstairs, he asked, "Ziye, it's only been a week since the surgery. We can continue to observe it. Maybe the effects are delayed?"

Fang Ziye gently shook his head: "I don't think so. Microcurrent stimulation therapy usually takes about a week to reach its peak effect."

"If there is still no effect after this time point, continuing will be futile."

"Professor Tang, this is a clinical research project, a clinical research project on spinal cord injury, which is different from all the projects I have led before."

The term "topic" originally refers to the main issues or major matters that need to be studied or discussed, or matters that urgently need to be resolved. Later, it was extended to mean the core issues or major social issues that need to be studied and resolved.

Clinical research projects are also a type of research project; they are established as such precisely because they cannot be solved otherwise. (End of Chapter)