Chapter 59: Trial and Error Treatment

Chapter 59: Chapter 59: Trial and Error Treatment

At nearly 5 p.m., Qi Yue gathered Han Shuo, Xie Jianmin, Wang Zhijin, and Wang Zejia in the main office to discuss the diagnosis for the patient, Xu Feng.

First, Yu Zhiming presented his hypothesis to the group.

’What an absurd hypothesis...’

Attending physician Wang Zhijin was the first to object. "Dr. Yu, there’s one piece of data I believe you must have overlooked."

"The Provincial Hospital in Lu Province performed viral cultures and tests on the patient during an episode of this unknown pain."

"The herpes zoster concentration they detected was only 0.01 pg/ml above the upper limit of the normal range."

"Just 0.01 pg/ml higher!"

Wang Zhijin repeated the number for emphasis, then continued, "A herpes virus concentration at this level is insufficient to trigger an outbreak."

Yu Zhiming replied softly, "Doctor Wang, I didn’t overlook that data on the herpes virus."

"I’ve memorized every single test result and data point for patient Xu Feng."

"I’d like to point out that the normal value for the herpes virus is just a range. It doesn’t account for the unique aspects of an individual’s constitution."

"Is it possible that the patient is simply highly sensitive to the herpes virus?"

"Or perhaps, before the attacks started, his body’s herpes virus concentration was far below the normal range?"

After a brief pause, Yu Zhiming added, "Ninety-five percent of the population carries the herpes virus."

"Before the attacks started, perhaps he was part of the five percent who don’t."

Wang Zejia, noticing that Qi Yue’s expression remained unchanged, chuckled and retorted, "Dr. Yu, your approach of assuming a conclusion and then trying to work backward to find a cause is nothing but a forced explanation."

"Blaming it on a unique constitution and a sensitivity to the herpes virus?"

"The world isn’t full of that many unique cases and coincidences."

Yu Zhiming smiled faintly and said, "Doctor Wang, we all get colds and fevers. It might be because one day we didn’t wear enough layers..."

"...then we get caught in a cold draft when our immune resistance is a little weaker, and just like that, we get sick."

"You could say that every illness is the result of various conditions and coincidences colliding in a perfect storm."

"This is true for minor illnesses, and it’s even more true for major ones, which are impossible without a mix of various conditions, coincidences, and the patient’s individual characteristics."

Yu Zhiming spoke with calm confidence. "Take patient Xu Feng’s condition. His case is currently the only one of its kind in the entire country. He is that unique, so why can’t his illness be the result of all these unique, specific, and coincidental factors converging?"

Han Shuo chuckled softly. "Well, I think Dr. Yu has a very good point."

"Quite a few of the patients sent to us have unique characteristics. We’ve had cases before where a patient’s unique physiology caused their symptoms to mutate and differ from the norm."

Xie Jianmin mused, "Assuming Dr. Yu’s hypothesis is correct, that would explain why we’ve been unable to reach a diagnosis."

"The herpes virus concentration was assumed to be within the normal range, which essentially put up a wall, blocking any doctors from speculating in this direction."

Xie Jianmin looked at Yu Zhiming and asked, "But there’s a problem with your hypothesis. Why hasn’t the hallmark symptom of a herpes zoster outbreak—clusters of blisters on the skin—appeared?"

Yu Zhiming explained, "I don’t have a good explanation for that, either. I can only attribute it to the patient’s unique constitution, or perhaps it’s being suppressed by some medicinal compound!"

Wang Zhijin scoffed.

"Dr. Yu, blaming everything you can’t explain on the patient’s ’unique constitution’—that’s just playing dirty."

"Healing patients requires hard evidence, not clever rhetoric. That’s completely meaningless."

Yu Zhiming chuckled. "I know it sounds like I’m trying to pull a fast one by attributing the parts I can’t explain to the patient’s unique constitution."

"However, if we operate under the assumption that the patient truly does have a unique constitution, then my hypothesis fits perfectly."

"So I propose, why don’t we test it..."

Yu Zhiming raised his voice. "Let’s run a test on the patient. Inject him with a suitable dose of immunosuppressants."

"If my hypothesis is correct, then after his own immunity is lowered, the herpes virus will activate somewhere in his body, and the severe, unknown pain will manifest."

"That way, we won’t have to just sit around foolishly waiting for who knows how long for the next episode of this unknown pain to occur."

"I disagree!"

Xie Jianmin’s tone was grave. "Dr. Yu, you are gambling with the patient’s life with this test."

"If it really is the herpes zoster virus at work, lowering the patient’s immunity like this could allow the virus to run rampant, invading his brain, liver, heart, and other organs."

"If that happens, no one will be able to save him."

Yu Zhiming argued, "Doctor Xie, I said a *suitable* dose of immunosuppressants. We would only be *moderately* lowering his autoimmune capabilities."

Xie Jianmin’s eyes flashed as he demanded in a loud voice, "Dr. Yu, what is a ’suitable’ amount?"

"Can you precisely control the degree to which his immunity drops, keeping it at a perfectly ’suitable’ level?"

Well...

Yu Zhiming thought to himself, ’How could I possibly have that kind of skill?’

’That’s a job for an oncologist who specializes in chemo and radiation, or an organ transplant specialist. They’re the ones who handle dosage levels.’

’They use immunosuppressants on their patients all the time.’

Yu Zhiming looked to Qi Yue for help, but he remained silent.

Xie Jianmin’s voice rang out again. "Personally, I believe the patient’s unknown pain is caused by some unknown virus or toxin."

"Dr. Yu’s experiment to lower the patient’s immunity would very likely allow that unknown virus or toxin to penetrate deeper into the patient’s body, causing fatal damage."

Wang Zhijin also stated his position. "Dr. Yu’s proposed test is indeed far too risky."

He then added in a low voice, "And somewhat irresponsible."

Wang Zejia also spoke up. "I think we should wait for the patient’s next pain episode. We can run a comprehensive examination at that time. Perhaps we’ll discover something new and get our answer."

At that moment, Han Shuo saw Qi Yue look his way and slowly voiced his own thoughts.

"Dr. Yu’s test is, admittedly, a bit risky."

"But just waiting around and doing nothing? That’s not our style here."

Seeing that everyone had stated their opinions, Qi Yue asked, "Do any of you have new ideas about patient Xu Feng’s condition?"

Xie Jianmin shook his head. "No."

He quickly added, "Chief, I’m in the middle of running viral cultures and screening for toxic substances. That’s going to take some time."

Meeting Qi Yue’s gaze, both Wang Zhijin and Wang Zejia shook their heads.

Qi Yue said in a heavy voice, "A considerable portion of the patients who come to us have difficult and complicated illnesses."

"There is no precedent for their diagnosis and treatment. A lot of the time, we have to feel our way forward as we go."

"Therefore, treatment by trial and error is unavoidable."

After a brief pause, Qi Yue declared his stance. "I believe Zhiming’s hypothesis has a certain degree of validity."

"I’ve decided to adopt Zhiming’s suggestion. Tomorrow, we will run a test on the patient to lower his body’s immunity."

"Chief..."

Xie Jianmin cried out, trying to persuade him earnestly, "The patient’s health is currently stable! There’s no need to rashly proceed with such a dangerous experimental treatment."

"Chief, we have time to proceed slowly and carefully."

Qi Yue insisted, "Doctor Xie, you know my philosophy. A bad course of treatment is better than delaying and doing nothing."

"No one can predict whether the patient’s next episode will be severe enough to endanger his life."

Qi Yue waved his hand, stopping Xie Jianmin and the others from protesting further, and gave a direct order: "Instead of wasting your energy trying to persuade me, you should start preparing a contingency plan for how to salvage the situation if the worst-case scenario you’re predicting actually happens during the experimental treatment."

He paused for two seconds, then said slowly, "If you want to convince me, then come up with a more plausible diagnosis than Zhiming’s before ten o’clock tomorrow morning."

Seeing Teacher Qi support him so decisively and adopt his hypothesis, Yu Zhiming felt both thrilled and apprehensive.

’If things really played out like Doctor Xie said, he would be the one responsible for the patient’s death...’