Chapter 94: Pharmaceutical Planning

Now, He Ma and Shi Niaoren worked together to ligate and cut the arteries to reduce bleeding during the dissection. Shi Niaoren picked up the aspirator tube from the instrument rack above the dissection table, stepped on the pneumatic valve to draw out the blood flowing into the abdominal cavity, and then suctioned out the blood from the thoracic cavity.

When He Ma began to peel back the scalp in preparation for opening the skull, someone finally couldn’t take it anymore and rushed out to vomit.

“Should we take a break?” Ai Beibei asked.

“Alright, we’ll be using the saw to open the skull in a moment,” Shi Niaoren said, rinsing the blood from his hands under the faucet.

After a ten-minute break, the dissection continued. Ai Beibei asked if anyone wanted to leave. No one did. It seemed they were made of the right stuff. Only by passing this test could they hope to become doctors.

However, when the saw began to cut through the skull, someone did leave, returning only after a long while. The sound of the surgical saw grinding back and forth between the skull bones was enough to make one’s blood run cold. Only someone like He Ma, who had worked in orthopedics, didn’t find it strange.

Shi Niaoren carefully pried open the skullcap, revealing the meninges covering the brain. This stimulus was enough to make a first-year medical student with weak nerves faint. He glanced at the nurses again. It seemed they could handle it. He noticed that some even had a look of euphoric fanaticism in their eyes.

“Attention! I’m cutting.”

Shi Niaoren gave a warning and used a pair of sharp scissors to cut a large vein running from front to back in the center of the meninges. He suddenly realized he had forgotten the name of this artery—was he getting old? Blood immediately gushed out, flowing onto the scissors and his fingers. He noticed the blood was flowing and there were no signs of embolism. This person had clearly not died of a cerebral infarction. He carefully observed the meninges before picking them open to reveal the brain. He used a scalpel to carefully separate the brain from the spinal cord and gently remove it. At this point, Ai Beibei brought over a glass jar half-filled with formalin. Shi Niaoren slowly placed the brain inside. The condition of this brain was excellent, and Shi Niaoren decided to preserve it as a specimen.

“This is the human brain. If the entire human body is a country, the brain is the imperial court,” he explained in simple terms, also explaining the differences and functions of the cerebrum, cerebellum, and brainstem. Shi Niaoren’s scalpel then turned to the heart.

Shi Niaoren removed the heart from the body and examined it carefully. He then turned his gaze to the young nurses and said:

“The most likely cause of sudden death is coronary heart disease. We will first check if this hypothesis is correct.”

The young nurses were now numb to the sight and began to focus on the organ itself, watching intently as he skillfully opened the coronary arteries.

“We should find the point of embolism here…” he said, pointing with the tip of a metal probe. “But there’s nothing. On the main branch of the coronary artery, there is no trace of any blood clot.”

“Now we will examine the heart itself.” Shi Niaoren placed the heart on the dissection board, cut it in half with a scalpel, and turned the two halves to examine them. Then he beckoned the nurses to come closer. They hesitantly gathered around.

“He clearly did not die of coronary heart disease,” Shi Niaoren said. “In this heart, there is no acute thrombosis, nor is there any sign of myocardial infarction complicated by a cardiac aneurysm.”

“Then how did he die?” Shi Niaoren pointed at the heart with the probe. “The left ventricle is significantly dilated, and there is grayish-white myocardial scarring. He had rheumatic heart disease during his lifetime. This is what caused his sudden death.”

He put down the probe. “Take a close look.”

He didn’t expect these girls to become real doctors in a year or two, but at the very least, he wanted them to overcome all fear and superstition about the human body.

Guo Fu had calmed down a bit now. She felt she could handle it. At the beginning of the dissection, when she saw the saw cutting into the dead man’s skull, she felt the blood drain from her head, and she became dizzy. At that moment, she felt she was about to faint, but she made up her mind to hold on.

For no apparent reason, she suddenly remembered something from her time as a wanderer. Tian Liang had once had a festering wound on his calf. By the time they reached a small town, he had a high fever. A traveling doctor, seeing their pitiful state, treated Tian Liang. He used a knife to cut away all the rotten flesh until fresh red meat appeared, and then applied medicine. No one dared to watch at the time, only she stayed by Tian Liang’s side to help the doctor. Tian Liang limped for several months before he fully recovered. She had taken care of him all that time, unafraid of the blood and pus from his wound, nor the terrifying wound itself. This gave her great strength. She knew that once she got through this, she would have no problem watching dissections in the future, and she could one day treat patients like the chiefs.

After explaining the lungs, the dissection demonstration class was over. He Ma put the removed internal organs back into the body—there was not enough preservative fluid to make specimens. These would all have to be wasted.

Shi Niaoren said, “Who wants to suture the incision?”

The girls looked at each other. This was a challenging task.

“I will!” Guo Fu stood up.

“Good. Go change your clothes. I want to see your suturing technique.”

The nursing school students had all learned how to suture wounds, but they had few opportunities to practice. Fortunately, suturing a corpse did not require much finesse, and there was no need to worry about scarring. Guo Fu sutured very carefully, though her skill was still lacking.

“Not bad,” Shi Niaoren nodded. He Ma also nodded, and Ai Beibei smiled faintly. Her technique was average, but her attitude was good. This girl had a promising future.

The body was washed with water, lifted from the table onto a cart, covered with a white cloth, and would soon be sent to Cuigang for burial. Although the anatomy room was in the basement and the temperature was lower, with so many people crowded together, the temperature was still over twenty degrees, and the body would soon begin to decompose. In a regular medical school or hospital, they wouldn’t have to do this themselves; someone else would handle it. Here, they had to do it themselves.

They changed their clothes and came out of the anatomy room, back to ground level. He Ma let out a breath and wiped the sweat from his forehead.

“We need to install an air conditioner.”

“I’d say it’s better to install a cold storage,” Shi Niaoren said, lighting a new cigarette. “The current temperature is really not good. It will be even worse in the summer. The room will definitely be as hot as a steamer, and the medicines won’t keep.”

“Li Xiaolv designed a ground-source air conditioning system, didn’t she? I think we can apply for one. After all, summer is coming,” He Ma said. As he spoke, the girls came out of the door, and Guo Fu walked over.

He Ma felt an indescribable, ambiguous feeling as the young girl approached. The well-starched blue uniform outlined her figure, and the slightly fluffy hair under her blue cap would be soft to the touch. He composed himself and said:

“Good job, Little Guo,” he praised.

“Thank you, doctor,” the girl blushed and lowered her head slightly. A faint fragrance emanated from her neck. Was this the natural scent of a virgin? He Ma’s mind wandered. Guo Fu was quite pretty—by 21st-century standards, of course. After several months of adequate food and exercise in Lingao, her figure was also very good. He Ma noticed that her breasts were not small. Although the blue nurse’s uniform was not a dress, it was quite form-fitting.

“Little Guo, come quickly,” Ai Beibei called her.

“If there’s nothing else, I’ll be going. Goodbye, doctor,” she smiled slightly, bowed, and turned away. I want this girl, He Ma suddenly decided.

Guo Fu caught up with the other girls. They were all asking her what she was thinking when she was suturing the corpse, and if she was scared. She answered casually, thinking that Doctor He’s gaze was very different—her face turned red again.

After sending the girls away, Ai Beibei returned to the chief physicians’ meeting room as usual to attend the weekly hospital-wide meeting. The so-called chief physicians’ meeting room was a large, comfortably furnished room with large glass windows and a few old sofas where they could sit comfortably, chat, and read newspapers and books. They all liked to sit here in their spare time; it felt more like the original time and space.

He Ping was on a circumnavigation voyage and had not yet returned. His wife, Zhao Yanmei, was there instead. She was a technician in a pharmaceutical factory’s mycology lab and had been tricked into joining the transmigration—He Ping had lied that a boss wanted to open a pharmaceutical factory.

Now, Shi Niaoren was indeed planning to put her in charge of the pharmaceutical factory.

“Meeting, meeting. Little Zhao, you’re in charge of the minutes,” the director called out. “Is Ziyi here? Go and get your husband. Yes, he’s a veterinarian, but he’s also a doctor.”

A moment later, Yang Baogui also arrived, his arms still wet, reeking of disinfectant.

“Another meeting? I was just inseminating a cow at the farm.”

The last to arrive was Liu San, a master of traditional Chinese medicine. He was now the head of the traditional Chinese medicine department, but he rarely showed up at the hospital, spending most of his time cultivating medicinal herbs at Wu Nanhai’s farm.

“Alright, let’s first review last week’s work progress,” Shi Niaoren opened his work notebook. “First, the completion of our operating room and anatomy lab…”

After much effort, Bairen General Hospital had built a decent operating room. The equipment and instruments were easy to come by; they were all brought from the other time and space, and the infirmary on the Fengcheng also had a simple operating room that could be used as a backup or a source of spare parts. The basic supporting facilities, however, were difficult to obtain. Things like tiles and porcelain sterilizing basins had only recently been transported from the porcelain kilns in Fujian. In addition, two surgical assistants had been trained from among the nurses. They could now handle major blood vessel and wound suturing, albeit barely. The only problem was the lack of a professional anesthetist. Every simple surgery turned into a scene of a poor soul howling in agony.

“…Our boiler room has been completed. The boiler workers are being trained by the Ministry of Energy, and the quotas for fuel and soft water have been approved. It should be fired up and put into use soon.”

The boiler room was a great convenience for Bairen General Hospital. First, they could use high-temperature steam for sterilization instead of the simple wet-heat method. A large amount of washing and disinfection work could be done in the hospital. They could also bathe in the hospital. As the weather got hotter, this was essential to ensure the hygiene of all inpatients and medical staff.

“…The agar for the microbiology culture room in the laboratory, we’ve reached an agreement with the navy and the Ministry of Agriculture’s biological laboratory. The navy will be responsible for supplying the raw materials, and the pharmaceutical factory will produce it uniformly. As for the equipment, it all arrived from the glass factory last week. It’s a bit crude, but it’s better than nothing.”

This microbiology culture room was very important for the hospital. They could now finally test for bacterial infections and infectious pathogens. In the previous stage, he had used water washing sedimentation and concentration methods to check for parasite eggs in random samples. In the past few days, he had found more than a dozen positive specimens every day. He was thinking about doing a general survey after a while.

“From the current situation, the infection rate of parasites has greatly increased, which indicates that the trend of eating wild food is on the rise. We need to notify the propaganda department to strengthen education in this area,” Shi Niaoren concluded. “Next, let’s have Director Ai talk about medical education.”

Ai Beibei adjusted her glasses. Having been in the United States for many years, she spoke Mandarin with a strange accent.

“The health training class we took over from the military and political school system is currently focused on nursing education. This is far from enough. At the very least, we need to train medical assistants with primary diagnostic skills.”

“Currently, the largest scale of training in this area is the cooperation with the army, navy, and the Ministry of Resources. The first batch of health workers, selected from both transmigrators and natives, has already graduated. The overall feedback is good. Once this becomes a system, it can guarantee the most basic military health needs in wartime.”

“I believe this is our training direction in the near future. This education is a crash course, teaching only practical skills and simple theoretical knowledge. It draws on the first aid training courses of non-governmental organizations like the Red Cross, training first-aiders in three-month units, specializing in first aid and simple treatment. We can also refer to the training system for rural barefoot doctors in the 1960s and 70s.”

Although the barefoot doctor system was eliminated after the reform and opening up, it is undeniable that this system covered the basic rural medical system at a lower level. This was a useful reference for the transmigrator group facing a similar environment, and Shi Niaoren deeply agreed.

“As for nursing training, the first nursing class has already graduated and been capped. However, their professional level can only be described as ‘unqualified’.”

Zhang Ziyi nodded. There was no doubt about this.

“Actually, they can only be considered nursing assistants. They have too few opportunities for practice, and there are not enough consumables and medicines,” Zhang Ziyi said. “There are no specimens, no equipment. Apart from alcohol and absorbent cotton, the nurses have almost nothing to use. Not even mercurochrome.”

Perhaps to emphasize her point, Zhang Ziyi counted on her fingers. “So far, the only things the nurses can use freely are: medical alcohol and saline for washing. We can’t even prepare sterile saline for injection.”