21st Century Necromancer

It was the regular pre-operative seminar held every week, and as usual, Doctor Chen Yu sat in his accustomed seat, listening to the doctor beside him explaining the details of the medical cases.

However, slightly different this time was the presence of Professor Zhang and his wife, along with Xu Xiaohong, who were there as guests for a medical collaboration project. They attended the seminar at the Tokyo University Medical School Hospital to understand the operation of Japanese hospitals and to absorb some advanced experiences.

Even though China’s medical industry, whether in terms of scale, grade, or technology, had developed very rapidly in recent years, and many aspects had already reached the forefront of the world, it is undeniable that in some aspects Japan still leads.

This was also why, even though Xu Xiaohong had to constantly translate, Professor Zhang and his wife still listened very seriously. These pre-operative seminars could indeed teach many things.

To make an inappropriate analogy, it was like a skilled, experienced doctor from a county or township hospital, who may be adept locally, but if he attended a seminar on case discussion in major hospitals in Beijing, Shanghai, Guangzhou, places like Xiehe or Ren’ai, even if it was just an ordinary case, he could learn many things he had never been exposed to before.

Furthermore, because of Japan’s tiered medical system, most cases that ended up at Tokyo University Medical School Hospital tended to be difficult and complicated that local hospitals couldn’t resolve, including not a few rare cases. These rare cases, which the Zhangs had never witnessed personally, proved extremely enlightening.

"The next patient, Haruka Mifune, female, 21 years old." As another patient’s medical record appeared on the large screen, the seminar continued: "The patient had a sudden onset of appendicitis three days ago and was transferred from the Hokkaido Wakkanai eighteenth branch hospital to our hospital yesterday. The attending surgeon is Doctor Kaji Hideki."

"Hey! This is my patient." Kaji Hideki raised his hand and stood up while explaining to the other doctors, "The patient was admitted to the Wakkanai branch hospital, but during examinations, a suspected case of appendiceal cancer was identified. After obtaining the patient’s consent, she was transferred to our hospital for treatment."

"Appendiceal cancer? Are you sure, Doctor Kaji?" A seated surgeon raised his doubt in response to Kaji Hideki’s introduction.

"Suspected, not yet confirmed. Since appendiceal cancer is a type of carcinoide, and appendiceal carcinoids are often low-grade malignancies with small tumors, typically less than 2 centimeters in diameter, it’s not possible to confirm the diagnosis until the appendix is surgically opened. However, based on the examination results, we cannot rule out the possibility of appendiceal cancer, which is why the patient was transferred to Tokyo for surgery," Kaji Hideki explained, signaling the doctor in charge of changing the slides to show Haruka Mifune’s CT images.

After observing the shadows on Haruka Mifune’s CT images, the doctors in attendance whispered amongst themselves and no longer raised any objections, accepting Kaji Hideki’s diagnosis.

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Professor Zhang, quite astonished by this turn of events, asked Chen Yu, "Chen Yu, it’s just a case of appendicitis, isn’t this taking things a bit too far? Even if there’s a possibility of appendiceal cancer, the surgery should be similar to that for appendicitis. Is it necessary for the patient to be transferred from elsewhere for the operation? Or are Japanese surgeons just especially thorough and meticulous?"

"No, Professor, you’ve got it wrong. It’s just that this Doctor Kaji wants to receive a gift money," Chen Yu laughed and explained to Professor Zhang, "Though it’s indeed possible to transfer a suspected case of appendiceal cancer from a branch hospital to the main hospital for treatment, even the branch hospitals in a place like Hokkaido would have adequate surgical conditions. With Doctor Kaji’s surgical skills, he could have performed the surgery using a laparoscope even in the branch hospital.

Having the patient transferred to Tokyo, partly because he had been reassigned back to Tokyo and wanted to bring the patient along for better treatment, was one reason; however, another very important reason was the expectation of the patient giving gift money.

Since Doctor Kaji took the trouble of bringing this patient to Tokyo for treatment, it can be inferred that the patient likely comes from a well-off family background and is able to provide a substantial amount of gift money, which is why Doctor Kaji is so invested."

As Chen Yu was explaining this to Professor Zhang, the slideshow on the big screen shifted to the next patient, who happened to be Wang Jiancheng.

"The next patient, Wang Jiancheng, male, 30 years old. Diagnosed with advanced ulcerative gastric cancer and stage three cholangiocarcinoma at the hepatic hilum. The patient was admitted to the hospital due to sudden gastric bleeding two weeks ago. During surgery, a gastric tumor was discovered and removed by surgeon Chen Yu. Subsequent examinations revealed cholangiocarcinoma at the hepatic hilum.

Due to the patient’s condition no longer permitting another liver tumor resection, he was transferred to our hospital for treatment under the auspices of a collaborative medical project between Japan and China, with Doctor Chen Yu as the attending physician."

Before the presenting doctor could finish, the doctors below had already begun discussing animatedly. Multicentric cancer such as in this case was very rare even at the Tokyo University Medical School Hospital. Additionally, the fact that the patient suffered from two malignancies not limited to a single organ made the case even more extraordinary.

"Professor Chen Yu, given that the patient’s condition does not permit another liver tumor resection, it would be better to transfer him to our internal medicine department for treatment. Based on his condition, if the surgery can’t be conducted soon, the patient may only survive for six months. However, if we proceed with the palliative non-surgical treatment in internal medicine, we could potentially extend the patient’s life to one year," suggested a physician from internal medicine, rising to argue for transferring the patient to their care, despite the announcement of the attending physician.

Hearing this, Chen Yu stood up with a smile. After taking a glance at the doctor, he shook his head softly and then turned to all the doctors to explain, "The patient’s cholangiocarcinoma at the hepatic hilum is a very challenging cancer within the digestive system. Even with surgery, the postoperative survival time, if optimistically estimated, is only around two years. While there are cases with longer survival, most patients’ lifespans are approximately one year.

So usually, as this doctor mentioned, opting for palliative non-surgical treatment in internal medicine indeed improves the patient’s quality of life and survival time. However, that is not the reason I transferred the patient from China to Japan for treatment."

"Could it be... Mr. Chen Yu, are you considering trying broad-spectrum targeted therapy for tumor cell activity inhibition on this patient? No wonder it’s a collaborative medical project between Japan and China. That’s your intention," Shimura Maru had already grasped Chen Yu’s idea.