A doctor who travels through two eras

One month later, at the Dizhu Village Health Clinic.

The village of Dizhu was particularly lively today, with Minister Li and Vice Minister Zhang from the Ministry of Health, Leader Li from Xiguang Province, and Director Shang Guangliang of the Health Department all present.

Also present were leaders in charge of medical and health work from various districts and counties of Tay Quang province, as well as heads of major hospitals and medical colleges.

Hundreds of people crowded together, filling the entire threshing ground of Dizhu Village.

The villagers had never seen such a spectacle before. The highest leader they had ever seen in their lives was the commune director, so all the villagers of Dizhu Village, and even villagers from several nearby villages, came to watch the excitement.

As a result, the hillsides surrounding the threshing ground were also densely packed with local people, making it far more lively than a local gathering.

Lin Sanqi was sitting among several leaders, explaining things to everyone:

Minister Li looked at the barefoot doctor in the white coat in the center of the threshing ground, who looked nervous, and asked softly:

"Xiao Lin, is it true that this young doctor has only been trained for a month?"

Lin Sanqi replied smugly:

“Minister Li, is this for real? When I arrived in Dizhu Village a month ago, this Doctor Wang Xidong was just the village clerk. He only graduated from junior high school and had no medical knowledge whatsoever. You can ask any villager if you don’t believe me.”

Minister Li is a woman, and women are more suspicious. She won't blindly believe everything she hears just because she has a good relationship with Lin Sanqi.

After all, this is a national-level task that concerns the health of hundreds of millions of farmers, and there can be no carelessness whatsoever.

So she stood up, walked to a small hillside filled with local villagers, and asked:
"Hello fellow villagers, I'd like to ask if this Comrade Wang Xidong has ever studied medicine before? Or does he have a family member who is a doctor?"

Upon hearing this question, the villagers of Dizhu Village began to answer in unison:

“Ah Dong used to be a clerk and also a scorekeeper, recording work results.”

“His family had been poor farmers for three generations. They only sent him to school because he was their only son. He didn’t get into a vocational school after junior high school, so he returned to the village.”

“No one in A Dong’s family is a doctor. There isn’t a single doctor in the surrounding area. Where did he learn to be one?”

Minister Li was relieved upon hearing this. Her question was random, and the people she asked were also random, so it was impossible for her to fake it or have arranged actors in advance.

Then, with a smile, he asked:

"So, folks, do you welcome this barefoot doctor program? Do you think it will help your lives?"

Upon hearing that the high-ranking leader from the capital was so kind and approachable, the villagers eagerly replied:

"Sir, we've been waiting day and night for a doctor to come so that we can get treatment when we're sick."

"Yes, Ah Dong became a barefoot doctor and brought back so much medicine. We're saved."

"We firmly support the leadership's barefoot doctor program, which truly serves us farmers."

Minister Li was even happier to hear this. As long as the Ministry of Health could gain the support of the masses and truly help the farmers, all its efforts would be worthwhile.

"Do you all think that the 5-cent registration fee, plus the few cents or dollars for medicine, is expensive? Can you afford it?"

The villagers were embarrassed at this point and clearly lost their confidence to speak.

A few cents is not a small amount for this remote mountain village.

An old farmer spoke first, replying:

“It only costs a few cents to treat an illness, it’s not a loss. If we get sick and are cured, we can work at home and support our families. If we, the strong laborers, fall ill, our wives, children and parents will starve to death, so a few cents for medicine is worth it.”

“Yes, in the past, when we got sick, even if we had the means to go to the county hospital, it would cost at least a few yuan, and there was no guarantee that we would be cured. Now there is a hospital and Western medicine right here in our neighborhood, so we can get medical treatment.”

Minister Li listened thoughtfully.

Her other personal idea was to establish a rural cooperative medical service center, where each villager would pay 1 yuan a year and then be able to get medicine and see a doctor for free.

The old lady believed that this was in line with the essence of socialism; how could farmers have to pay for every medical visit out of their own pockets?

However, Lin Sanqi firmly opposed this, believing that such a system of equal distribution of resources would only lead to a lack of enthusiasm among doctors, poor attitudes, and that the clinic would not stock any good or effective medicines in order to save costs.

Of course, Lin Sanqi also had his own solution, which was to lower the price of the medicine.

Take ibuprofen tablets, for example. A box of the better-quality "Fenbid" costs more than 20 yuan. However, in hospitals, a bottle of 100 ibuprofen tablets costs 6 yuan, which works out to 6 cents per tablet.

This is still the price from 2016.

Another option is the well-known antibiotic, cefuroxime, a box of 12 tablets, which can cost more than 30 yuan for some and as little as 5 yuan for others.

Lin Sanqi removed the cephalosporin packaging, discarding the outer shell and plastic blister pack, and made it entirely into tablets, with each bottle containing 100 tablets.

The cost of a bottle of medicine can be reduced to about 10 yuan, which translates to 1 cents per cephalosporin tablet.

The prices listed above are from 2016. To ensure that doctors from 1964 could still make a profit, Lin Sanqi kept the prices at the original rates.

That is, a bottle of cefuroxime costs 10 yuan, and the barefoot doctor can earn 3 yuan.

This solves the problem of expensive medicines, making medicines affordable for ordinary people and giving them the confidence to go to the hospital.

This also guarantees the barefoot doctor's income. Even if you sell 10 bottles of cephalosporin in a month, your income can reach 30 yuan, which is an astronomical figure in rural areas.

Minister Li returned to the observation seats, at which point Wang Xidong, the newly appointed barefoot doctor of Dizhu Village, prepared to demonstrate how to treat patients.

They were surrounded by hundreds of government officials, thousands of local villagers, and five video cameras and reporters constantly taking pictures.

Wang Xidong was covered in sweat, and his hands were trembling with nervousness.

Lin Sanqi shouted after seeing this:
"Comrade Wang Xidong, don't forget that this is the birthplace of the Dizhu experience. If you do a good job today, it will be a great honor for your ancestors. So you must stay calm, be meticulous, and treat the patients well."

Upon hearing this, the old village chief also shouted, "Adong, you must bring honor to our Dizhu Village!"

Hundreds of villagers from Dizhu Village also shouted:
"Go, Adong!"

"Don't be nervous, we've got your back!"

Hehehe~~~ Everyone at the scene, from leaders at all levels to local residents, laughed heartily.

Wang Xidong took a few deep breaths before nodding.

Today, he went to see a doctor in the center of the threshing ground. He checked his work again and looked around at the medicines in the cabinet before speaking:

"First villager, come here for a medical checkup."

Wang Xidong's wife is acting as a temporary nurse today. Barefoot doctors have become her family's business, and she naturally gives her full support.

The scene fell silent instantly.

A microphone was placed on the table where Wang Xidong was seeing patients, so that everyone present could hear the entire consultation process.

The first patient was an elderly woman who was helped over by her two sons.

Everyone saw that the old lady was coughing incessantly, and her legs were weak when she walked, so she had to be supported by her two sons.

Everyone present was thinking, "This old lady is seriously ill; she can barely walk. Is this barefoot doctor any good?"

Actually, no one expected that the old lady was just too nervous and frightened.

Wang Xidong took a few deep breaths before asking the question:

"Ah You's mom, where do you feel unwell?"

The old lady coughed a few times before speaking:

"I'm coughing terribly, and I feel like I have a fever. My whole body is burning up. Ah Dong, what illness do I have? Is it curable?"

Lin Xidong glanced at the small red booklet on the table, "The Barefoot Doctor's Manual," and recalled how to handle the situation.

"Ah You's mom, let me take your temperature first, and then I'll listen to your lungs, okay?"

The deans of major hospitals and medical schools present were in an uproar:
"These farmers can listen to lung sounds after only one month of training? That's impossible, isn't it?"

"That's right. Even vocational school graduates may not be able to master lung sounds by the time they graduate. How can a farmer do it?"

Lin Sanqi knew that others would have this question, so he asked his secretary to bring over a tape recorder.

"Okay, everyone, please be quiet for a moment. I'll play a few audio clips for you to listen to first."

The hospital directors, doctors, and experts present all quieted down, and soon a special sound came from the recorder.

One of the hospital directors exclaimed, "This, this is pulmonary rales?" The tape recorder was playing a series of noises; to outsiders, these whooshing and chattering sounds were just vocal cord sounds. Why wasn't there any music?

However, professional doctors and professors can tell that these are abnormal breathing sounds.

After everyone had listened to it once, Lin Sanqi turned off the recorder before speaking:

"What you just heard was lung auscultation sound, such as normal breath sounds, including bronchial breath sounds, vesicular breath sounds, and bronchovesicular breath sounds."

There may also be abnormal breath sounds, such as dry rales, wet rales, wheezing, and pleural friction rubs.

This moist rales, as observed on auscultation, are characterized by being prominent at the end of inspiration, intermittent and brief, similar to the sound of a blister bursting. Those present are all senior members of the healthcare system and should be able to distinguish them easily.

Let's break it down further. For example, coarse moist rales, also known as large crackles, are commonly seen in patients with pulmonary edema or coma; medium moist rales, also known as medium crackles, are commonly seen in bronchitis and pneumonia.

Finally, there is a fine, moist rales, which sounds like small bubbles bobbing around. This indicates inflammation and exudation in the alveoli, such as pulmonary congestion or interstitial pneumonia.

What I'm talking about is theory, which may be difficult for laymen to grasp, but I'm now letting the barefoot doctor listen to the sounds from this tape recorder.

I listen to it for them every day, dozens of times a day. Tell me, do you think these young barefoot doctors can remember it? Our medical education, to put it bluntly, is about listening more, learning more, and memorizing more.

Previously, when medical students went to hospitals for internships, they would hear these sounds from patients. After hearing them many times, the medical students would remember them and gain experience.

Now, listening to recordings makes auscultation much more convenient, and the sounds are more typical. Barefoot doctors no longer need to fuss over the doctors. Even if they forget what they heard this year, I can play it for them again next year. Do you think they'll remember it?

"Wonderful!"

One of the deans stood up excitedly:

"Minister Lin, this can be perfectly applied to medical education. It's so convenient and practical."

Lin Sanqi waved his hand:
"Sit down first. Don't worry, I'll prepare the tape recorder and tapes for everyone. Our medical education needs to keep up with the times."

Hehehe~~~ Everyone in the room chuckled.

Wang Xidong then put away his stethoscope and said:

“Ayou’s mom, you have lung inflammation and your temperature is 38.5 degrees Celsius, which is quite serious.”

Huang Ayou, the son, panicked upon hearing this:

"Ah Dong, what should we do? My mom has pneumonia. Can you help her? I'll borrow as much money as I can."

Upon hearing this, the other villagers were also in an uproar and began to discuss it amongst themselves.

Even the hospital directors frowned and became serious.

For farmers in the 1960s, pneumonia was equivalent to an acute illness, or even a terminal illness.

In rural areas where there are no doctors or medicines, the mortality rate is over 50%, and for elderly people with pneumonia, the chances of survival are almost nil.

Wang Xidong was actually a little nervous, but he remembered what his teacher had said during training: doctors must remain calm, even if they have to pretend to be calm.

After all, if the doctor panics first, the patient will panic even more and could potentially die of fright instead of from the disease.

“Ah You, don’t worry. Pneumonia used to be a serious illness, but now I’m here. Don’t worry, with me here, your mother won’t die.”

After comforting the villagers, Wang Xidong turned to the old woman and said:

“Ah You’s mom, you have pneumonia. I have the best anti-inflammatory and fever-reducing medicine on hand. As long as you take the medicine on time every day, I guarantee you will be cured within a week.”

The old lady was just wiping away tears, feeling like she was about to die, but now she's happy to hear this.

Who wants to die when they can live?

"Ah Dong, it's good that we have medicine, but please don't make it too expensive, we can't afford it."

Lin Sanqi then asked Director Li of the Xiguang Provincial People's Hospital who was standing next to him:
"Dean Li, what are the steps involved in treating pneumonia? And what is the approximate cost?"

Dean Li replied softly:
"Pneumonia requires hospitalization, blood tests, and X-rays. If available, penicillin should be administered; if not, oxytetracycline can be used. The more expensive option will cost around 50 yuan, while the cheaper option will still cost at least 30 yuan."

An X-ray costs 10 yuan, and penicillin is even more expensive; it's not something ordinary people can afford.

The workers are alright; they have government-funded medical care, and the factory can reimburse some of their expenses.

Farmers, on the other hand, can only wait to die; a few dozen yuan is an unbearable burden for them.

Wang Xidong stood up, took out a paper bag, and put 10 cefuroxime tablets into it. He then put 6 ibuprofen tablets into another paper bag.

"Ah-you, these are two kinds of medicine. One is an anti-inflammatory, and the other is a fever reducer. Take one pill of each twice a day. Don't forget. If you really can't remember, just come and ask me again. Also, you should have some houttuynia cordata at home, right?"

Huang Ayou nodded repeatedly:
"Yes, yes, we have both fresh and dried ones."

Houttuynia cordata is also known as fish mint. People from other regions turn pale at the mention of it, thinking it is the most unpalatable thing in the world, but it is the most beloved wild vegetable among the people of Yunnan, Guizhou and Sichuan.

Especially in the 1960s, every household picked it to eat as a vegetable, or even as a staple food.

Wang Xidong instructed:

"When you get back, boil some houttuynia cordata in water and give it to your mother to drink. Add a little salt to it. Houttuynia cordata has the effect of clearing heat and detoxifying, and has certain antibacterial and anti-inflammatory effects. It will be good for your mother to drink it."

Fever can easily lead to electrolyte imbalance, and sick people often don't like to eat or drink, which can worsen their condition.

People in rural areas say that someone died from a fever, which is actually caused by dehydration or electrolyte imbalance.

At this point, after receiving an IV drip at a large hospital in the city to correct dehydration and electrolyte imbalance, I recovered quickly.

However, in rural areas, it is almost a dead end, because there is a strict formula for fluid and electrolyte replacement, and doctors need extensive clinical experience, which is impossible to obtain in rural areas.

Wang Xidong's use of both cephalosporins and houttuynia cordata is a typical example of combining traditional Chinese and Western medicine.

Historically, barefoot doctor training took two months because it required extensive training in traditional Chinese medicine knowledge, which was very complex and time-consuming.

However, Lin Sanqi's version of "The Barefoot Doctor's Manual" mainly focused on Western medicine, making treatment relatively simple, and the training time was compressed to one month.

The reason why complex Chinese medicine knowledge was not removed is because Lin Sanqi had reservations.

What if the supply of Western medicine is not timely, or the transportation lines are disrupted? What will the barefoot doctors do? Will they stop treating patients?

Therefore, learning basic Chinese medicine knowledge and copying down a few classic and commonly used prescriptions for future use was a basic requirement for barefoot doctors.

After receiving the pills, the old lady asked nervously:

"Ah Dong, how much does it cost?"

Wang Xidong smiled and said into the microphone:

“头孢1元钱，布洛芬3角6分，再给5分钱挂号费，你一共给我1元4角钱吧。”

Wow! The audience was in an uproar when they heard that number.

The hospital directors thought it was too cheap; this wasn't treating pneumonia, it was clearly treating a common cold.

However, most villagers still felt it was too expensive. 1.4 yuan was equivalent to 7 jin of rice or 2 jin of fatty meat, plus some wild vegetables, which could last for a month.

Upon hearing this, Huang Ayou and his younger brother breathed a sigh of relief and took out a pile of loose change from their pockets, counting it one by one.

At this moment, Wang Xidong took the microphone and spoke to the surrounding villagers:
"Ayou's mother has pneumonia, which is quite severe, so the cost is a bit higher, and the high cost is mainly due to the cephalosporin antibiotic."

If it's just a common cold, you only need to get medicine for two days, which will only cost a few cents. Don't worry about not being able to afford medical care.

Alternatively, if you really don't have cash, you can give me equivalent amounts of food, such as rice, sweet potatoes, or corn. You can also catch some pheasants or rabbits, or get some fish.

If all else fails, we can dig up some Chinese medicinal herbs. There's always a way out. We can't let ourselves die from holding our pee, can we?
We barefoot doctors won't refuse any supplies; after all, our primary responsibility is to treat and save lives. We just need to make sure we don't lose money.

Wang Xidong's statement was very important, and it was all recorded by several cameras.

Upon hearing this, Minister Li slapped his thigh in excitement:
“Good, this is a good idea. Farmers are poor, they really don’t have money. But even if they don’t have money, I believe most farmers can manage to get some grain or wild game, which will solve the problem of medicine costs.”

Upon hearing this, the observing leaders also agreed that the policy was good.

"Yes, no matter how poor you are, you always have something at home."

"If you can't borrow money, you can always borrow some cornmeal from relatives or villagers."

"Even if you catch some fish or dig up some loaches in the river, if you don't find any, it means that this person either has poor interpersonal relationships or is too lazy."

However, some people disagreed: (End of this chapter)