Mastering the Sword Manual, sweeping across the globe

After reading it, Lao Liu closed the medical record.

Yes, I put it in front of myself and didn't return it to Zhuang Yan.

“Mr. Zhou, I have a general understanding of your brother’s condition… Lung adenocarcinoma, stage III, and the gene test results show that he is EGFR mutation positive. This type is within the scope of our assistance.”

"Really?" Zhuang Yan feigned relief. "That's great! Then... then what should I do..."

“However,” Old Liu raised his hand, interrupting him, “before that, I need to confirm a few things. First, where was the original data for your brother’s genetic testing report obtained? We need to retrieve the complete original files.”

"The original file?" Zhuang Yan was taken aback. "Isn't it in the medical record?"

“The medical record only has an abstract; we need the raw data from whole-genome sequencing.”

Zhuang Yan's heart skipped a beat.

The other party's level of expertise exceeded Zhuang Yan's expectations.

"Secondly," Lao Liu continued, "your brother needs to undergo a genetic retest at our designated third-party testing institution... Of course, we will cover the cost. However, the sample must be provided by him in person, either through a blood test or an oral swab."

“Third,” Old Liu pulled another document from his briefcase and pushed it in front of Zhuang Yan, “If the genetic testing passes, your brother will receive full funding. This includes, but is not limited to: round-trip transportation, accommodation, meals, translation services, and all treatment costs at the cooperating hospitals in Y City… Um, you need to sign this document.”

Zhuang Yan looked down.

The cover of the document has a line of bold text: "Informed Consent Form for Funding Severe Illness Treatment".

Zhuang Yan opened the book and quickly browsed through it.

The terms are numerous, but the core meaning is clear: the recipient voluntarily accepts all arrangements provided by the funder, who does not charge any fees, demands any returns, or interfere with any medical decisions.

Zhuang Yan finished flipping through the documents and looked up.

"that's it?"

That's all.

"Are there any additional conditions?"

"No."

"So... what are you after?" Zhuang Yan asked this question, trying his best to sound like an honest man who had been hit by a windfall.

“Mr. Zhou,” Old Liu looked at him and smiled, “In this world, some things don’t need a reason… Your brother needs a good treatment environment, and we happen to be able to provide that environment, that’s all.”

Zhuang Yan hugged the documents tightly to his chest: "Then I'll go back and discuss it with my brother."

“Of course,” Old Liu stood up and shook hands with Zhuang Yan. “Just give me an answer within three days… After three days, this spot may have to be given to someone else.”

Old Liu is gone.

Zhuang Yan sat in the tea room, staring at the cup of tea in front of him that he hadn't drunk a drop of.

Zhuang Yan included a miniature location sticker in the medical record he provided to Lao Liu.

The stickers are as thin as a layer of glutinous rice paper. They are stuck to the corners of the pages and are almost invisible to the naked eye. The newspaper purchased them last year. The last time they were used was to track down a group of fake drug dealers, and they worked very well.

At the same time, Zhuang Yan also noticed that Lao Liu put the documents into the inner compartment of his briefcase, where other medical records were obviously also placed.

The sticker's signal came back quickly, but only for a day.

The signal completely disappeared shortly after noon the next day.

Zhuang Yan was not giving up and decided to go directly to the person.

When Lao Liu reappeared at the Second Municipal Hospital, Zhuang Yan recognized his back view across the corridor.

Old Liu was queuing in the outpatient hall with a patient's family member. Zhuang Yan pretended to pay at the window next door and followed them from the fourth floor to the first floor, and then through the corridor to the inpatient department.

At the entrance of the inpatient department, Lao Liu was stopped by two people in white coats.

Zhuang Yan saw them exchanging a few words from afar. Old Liu took out a few sheets of paper from his briefcase. The other party looked at them, nodded, smiled, and let them in.

Zhuang Yan was unable to follow them inside.

The inpatient department needed to verify the family members' information, and his false identity could not withstand close scrutiny.

Zhuang Yan sat on a bench downstairs for an hour, watching the lights in the inpatient ward come on one by one. The warm yellow light seemed particularly comforting in the cool autumn evening.

A few hours later, Zhuang Yan inquired through a nurse who had previously given him the inside scoop. The nurse said that the patient that day was an overseas Chinese who had returned from Northern Europe. He had late-stage liver cancer, and the admission procedures went smoothly. The genetic test results were expedited that afternoon.

"Don't you find it strange?" Zhuang Yan asked. "A Chinese from Northern Europe, instead of going to a high-welfare hospital, came to Y City, and someone even helped him with all the paperwork."

"The income of the International Special Needs Department goes partly into medical insurance subsidies and partly into performance bonuses for medical staff," the nurse replied, seemingly ignoring the question.

Zhuang Yan was speechless.

He then found Nguyen Thi Lien.

She was still in that corridor, sitting on a bench with a thermos containing freshly cooked porridge on her lap.

Zhuang Yan sat down next to her and asked her how her husband was doing today.

She typed: I feel much better today. I drank a bowl of porridge by myself this morning. The doctor said the indicators are moving in a positive direction.

Zhuang Yan asked her, "Do you know why the sponsors are helping your husband?"

She typed: "They've seen his report and said he meets the requirements. I don't understand any of that. All I know is that he's my husband. When we got married, he was willing to give me anything. Now that he's sick, I'll give them anything they want as long as he gets better."

After typing that line, she hugged the thermos to her chest and turned her head to look at the door at the end of the corridor.

This time, Zhuang Yan followed her gaze and saw that there was actually a small window on the door, through which a small section of the corridor could be seen. A doctor in a white coat was passing by there, walking very fast, the hem of his white coat fluttering behind him.

Nguyen Thi Lien suddenly smiled and typed: The doctor said that in a few more days, once his vital signs stabilize, he can be transferred to a regular ward. Then I can go in and be with him.

Zhuang Yan then sought out Diao Sujian, whom he had met during the previous interview.

This is a third-generation Chinese Cambodian. His ancestors were once wealthy, but now they are clearly in dire straits. However, he is quite optimistic: "The doctor said that my genetic report is very special, so special that someone is willing to help me pay for it. I can't even afford a train ticket to Phnom Penh. Now, I have returned to my ancestral homeland. Even if I can't get a seat, being able to eat in such a rich country for a few months is worth it in this lifetime."

On a bench outside the hospital, José Liu told Zhuang Yan in broken Chinese, a mix of Spanish and Hakka: “My grandfather was from Guangdong, and my grandmother was from Lima. I grew up in Peru, but I have a Chinese household registration, which my grandfather helped me obtain when he returned to China... I am half and half of my genes.”

His phone screen was still lit up, showing a video call interface. A little girl's face was paused on the screen, her mouth open, probably calling for her father.

“Sir, I don’t know what experiments they’re doing with me, or what they want. But if my genetic report allows me to live, then let them have it.”

After the interview, Zhuang Yan spent several days meticulously piecing together information about José Liu's sponsors, following each lead one by one. The results were far more complex than anticipated.

The first tier of the funding network consists of well-known, long-established medical charities.

For example, a certain foundation has donated to build more than 200 health centers in the inland areas of Da Yang over the past 30 years, and it has always been at the top of the list of donors to disaster areas.

Another example is a certain foundation that has long funded infectious disease prevention and control and the training of grassroots medical personnel in impoverished areas, and has consistently received the highest international credibility ratings.

Another example is a foundation that has consistently insisted on opening clinics in refugee camps in war-torn regions, and whose field data has been cited countless times in the International Red Cross's annual reports.

However, the organization that has funded the most people is a new organization on the shores of Lake Geneva that was established less than two months ago, called the "Global Cancer Genomic Diversity and Precision Medicine Foundation".

The fund’s core objective is equally lofty: to promote access to precision medicine for cancer patients in low-income countries.

At the same time, Zhuang Yan discovered a very interesting fact: the fund's beneficiaries are first- or second-generation overseas Chinese from Peru, Bolivia, Guatemala, Chile, Mexico, Cuba, Puerto Rico, Brazil, Argentina, Fiji, Samoa, Tonga, and Mauritius.

When these place names are listed together, a layman would think they are from all over the world.

But Zhuang Yan, a journalist who has won the public health reporting award twice, has a very special advantage: he knows many friends who work in epidemiology and human genetics.

He sent the list to an expert, who called back after reviewing it, his voice unusually excited.

"This is about finding common sequences."

A friend told Zhuang Yan that these countries and regions share a common genetic characteristic: they are all intersections of multiple large-scale migrations and gene exchanges in human history.

In these regions, it is easy to find a large number of non-pathogenic loci at the whole genome level, especially among mixed-race individuals, who have a higher proportion of conserved sequences across multiple races.

These individuals' genotypes are like keys, each with teeth that can fit into several different keyholes simultaneously.

"Does this practice affect the localization of disease-causing genes in the Dayang ethnic group?"

"What impact could this have?" My friend found it strange. "It's just that it's gone from only targeting the CR gene group, well, that is, the large proportion of the population you mentioned, to being effective for the vast majority of human gene groups, which greatly expands the area of ​​benefit."

Zhuang Yan slowly hung up the phone.

He walked to the window and looked at the people coming and going on the street outside.

Some people were carrying CT scans to the hospital, some were queuing up at the patient service center to get ginger tea, and some were squatting by the roadside eating boxed lunches with medicine packets they had just taken from the traditional Chinese medicine pharmacy next to them.

These people had different expressions; some looked worried, while others walked briskly.

But they all have something in common: they came here because this place gave them an answer that they couldn't get anywhere else.

He reopened the list of grant recipients and discovered a detail he had previously overlooked: the list contained neither purely European nor purely African individuals.

Each recipient of funding maintains an East Asian profile in appearance and legal identity.

They don't cross that red line.

Staring at the place names on the screen, Zhuang Yan recalled Nguyen Thi Lien holding a thermos and waiting outside that door, José Liu showing his daughter a video and saying, "Dad has found a way," and the elderly couple of the Chinese expatriate in Northern Europe standing at the door of the ward, leaning on the door frame and looking inside for so long.

These people are not data, not samples, and not materials for genetic analysis.

They are simply sick people, and people who love them.

What are those people behind all this doing, carefully avoiding all the red lines and probing the boundaries of that target point in the most precise way?

The answer has always been there.

Regardless of the ultimate goal behind charitable foundations, their actions are aimed at enabling more people to live.

Zhuang Yan stubbed out his cigarette, sat back down at the table, turned the recording back on, and listened to it from the beginning.

That evening, he wrote the opening of a report.

I wrote half of it, then closed the document, opened a new blank document, wrote three paragraphs, and then deleted it.

After repeating this several times, he leaned back in his chair and stared at the ceiling for a long time.

162 Parents' Hearts

The meeting room of Huimin Street Health Center in Chengxi District, Y City, is on the third floor. It is actually a small room partitioned off from the top half of the floor.

The window faces east, and the morning sunlight is filtering through the gaps in the blinds, cutting thin strips of light onto the long table. Three of the blinds are stuck and cannot be adjusted; they were damaged by a typhoon last summer and have not been repaired by the maintenance department.

Not everyone showed up.

The street health center only has about ten people in total. At this time, in addition to Director Zhou, there was Dr. Sun, the director of internal medicine, Dr. Liu, the head nurse, Sister Zhao from the pharmacy, and Xiao Chen, who was in charge of medical insurance settlement.

There were also two people sitting in the meeting room who had come from the neighboring community health service center to observe the meeting. They said they were there for exchange and learning, but actually they just wanted to see how things were done here.

Old Zhou's thermos was on the table, with the words "Y City Health System Table Tennis Tournament Commemoration" printed on the inside, and most of the paint had been worn away.

"Let's have a quick meeting," Old Zhou said as everyone was mostly present. "Recently, we've admitted a few patients with rather unusual conditions... Xiao Chen, you go first and tell us about them."

Xiao Chen is a young woman in her early twenties who has been a civil servant for less than two years and is not yet used to speaking in this kind of setting.

She opened the folder in front of her, cleared her throat, and spoke in a voice that was half an octave higher than usual.

"In the past two weeks, our hospital has admitted a total of seven special cases. Three cases of lung cancer, two cases of liver cancer, and two cases of pancreatic cancer. All of them were in the late stage, all of them held domestic household registration, but had been working or living abroad for a long time... Well, three of them came from Southeast Asia, two from South America, and two from Fiji and Samoa."

"Where is Samoa?" asked Head Nurse Liu.

“South Pacific Ocean, next to New Zealand,” Xiao Chen replied. “I don’t know how they found us here… But the medical records are all genuine, CT scans, pathology reports, and genetic testing reports are all complete, all done by top-tier hospitals in China.”

Dr. Sun slammed his thermos on the table: "A top-tier hospital needs a report, so they're being admitted here?"

“Those who are ranked among the top three hospitals outside the province… those who can get in line within the province would never come to us.”

"Are you burning money?"

“Someone is funding it…a charitable foundation is covering the costs.”

The meeting room was quiet for a moment. Old Zhou looked down at the hospital registration form in front of him.

“And another thing,” Xiao Chen turned a page, “of these seven cases, five have already tested positive for EGFR or ALK mutations… someone behind the scenes has specifically screened them.”

The group exchanged glances.

The meaning is clear: someone outside is using the most sophisticated genetic screening technology to pick out people one by one and then precisely put them into the medical system of Y City.

Even the local health center, which doesn't even have an operating room, has become a link in this precision medicine delivery chain.

"Transnational medical care...tsk tsk tsk, these funds really have plenty of money." Old Liu remarked.

Director Sun picked up the enamel mug on the table and took a sip of water: "I have a journalist friend who has specifically investigated this matter. These foundations are all legitimate in the charity circle; they are not some shady, unorthodox methods."

"The question now is, what do the higher-ups think?" Sister Zhao asked.

“I made a special trip to the higher-level authorities last week and reported to Deputy Director Qian of the Medical Administration Department in person,” Lao Zhou said. “His exact words were: ‘Medical technical issues are professional matters, and the administrative level will not interfere.’ I also asked whether there should be a limit on the proportion or whether separate files should be created. His attitude was: ‘This is a matter for the hospital and doctors to decide based on their professional judgment.’ In short, he didn’t give a single definite answer, and he didn’t say a single word of obstruction either.”

"What does the higher-level hospital think?" Sister Zhao asked again.

“I’ve asked around,” Lao Zhou continued. “The gist of it is: if they want to take it, they can; each department will only make its own professional judgment.”