Chapter 192: A Costly Diagnosis

For ordinary people, nothing is more terrifying than cancer.

Because cancer epitomizes death and a terminal illness in many minds.

“This is a chronic inflammatory bowel disease, not cancer. Although some call it the green cancer, it is nowhere near as frightening. However, with current medical standards, it requires lifelong medication and we can’t completely cure it for now.”

Dr. Jia explained to her.

The girl’s face turned noticeably pale, her expression tinged with desolation.

While the diagnosis was slightly better than she had feared, the phrase ‘green cancer’ still imposed a heavy psychological burden.

Especially since the idea of an incurable disease that demands lifelong medication is a bolt from the blue for anyone.

“Dr. Jia, just prescribe the medicine already! I thought it was cancer—this result is far better than I expected,” she said, her voice strained with a forced cheerfulness.

Dr. Jia did not rush to prescribe anything; instead, he continued to analyze her condition.

“Your disease is in an acute flare-up with signs of fluid, electrolyte, and acid-base imbalance. Fortunately, there is no intestinal perforation yet. That is something to be grateful for. However, be wary of a transmural inflammatory lesion that might erode through the intestinal wall, forming a fistula. If you feel any severe discomfort, come back for a check immediately.”

Once an internal fistula forms, it can join with other bowel segments, the mesentery, bladder, ureter, or even parts of the peritoneum.

If an external fistula develops, it will extend to the abdominal wall or the skin surrounding the anus.

At that stage, both the treatment costs and patient suffering will increase dramatically.

Therefore, any illness, once detected, must be met without fear and treated promptly.

Delays are not an option.

Every moment postponed only makes the disease worse.

For instance, treat chronic kidney disease as soon as abnormal urinary protein levels are noticed; early intervention is far more effective.

If you wait until the kidneys shrink irreversibly, your only choices will be transplantation or dialysis.

Too many cases of uremia are simply the result of postponement.

“Now, let me outline the treatment plan. So far, we haven’t detected any intestinal perforation, abscess, obstruction, or fistula, so surgery isn’t necessary for now – oral medication will do. There are domestically produced drugs for this condition, but foreign medications generally have superior research and production standards. Most domestic options are generics. If circumstances allow, I recommend choosing imported medicine.”

Dr. Jia chose every word with careful deliberation.

Perhaps because she was so young – a poor response to medication could have disastrous consequences.

“Of course, if finances are tight, you can begin with domestic generics,” he added.

Dr. Jia understood that this girl, with no one else to rely on and so young, likely had very limited funds.

But a doctor’s heart is as caring as a parent’s.

Doctors always strive to recommend the best treatment available.

Many only know that Indian generics are famous, though our own pharmaceutical capabilities aren’t bad.

It’s just that some drugs, protected by intellectual property and patents, have no generics.

However, we must admit that in terms of medical devices, consumables, and Western drugs, our country still lags well behind developed nations.

Take consumables for example: domestically made artificial blood vessels tend to calcify and degrade faster in the body, with lower patency rates compared to their foreign counterparts. Their durability and finer details differ significantly.

So, the gap remains substantial.

Indeed, many surgeons—especially on critically ill patients—prefer imported essential consumables and medications.

“I even came from another province specifically to see you because I trust your judgment. Since you strongly recommend imported drugs, I will opt for them first. If they end up being too expensive, then there’s nothing we can do.”

She was refreshingly straightforward.

“An imported treatment lasts about two months per dose, costing roughly 15,000 each time. Does that work for you?”

At 7,500 a month, it is an immense financial burden.

After finishing his explanation, Dr. Jia quietly awaited her decision.

“And what about the domestic medication? How much per dose?”

The girl’s reaction showed that the steep cost was far beyond her price range.

“It’s roughly 5,000 per dose, though the price may fluctuate. With domestic drugs, the risk is that complications or a failure to control the disease may arise, which would be troublesome.”

Dr. Jia offered his guidance.

Ultimately, the decision on treatment lies with the patient.

Typically, we discuss the pros and cons, then let the patient decide.

Often, some patients, when told they must be hospitalized, undergo surgery, or even get a stoma—or that the medication only delays the disease—choose to forgo treatment altogether.

Others, after leaving, turn to traditional or alternative remedies on their own.

“I’ll go with the imported medicine! As long as I stay healthy, even if my salary falls short, I can work a side job after hours. I just hope that medical research will eventually develop a cure for this disease.”

In the end, she opted for the imported treatment.

Dr. Jia then issued a prescription along with related medical advice.

With the payment slip in hand, she departed.

So many patients share her hope—that a definitive cure will be developed soon.

After sending her on her way, Dr. Jia turned his attention to another patient.

“Dr. Jia, please take a look at this. I had a gastroscopy done at the local County People’s Hospital.”

The patient was a woman in her forties, accompanied by her husband.

Both had tanned, weathered skin, wore simple clothes, and their calloused hands spoke of hard labor.

They were a farming couple.

Zhou Can observed from the sidelines and quickly deduced their background.

“Whoa, there’s an indentation in her stomach!”

At the sight of the gastroscopy images, Dr. Jia sighed as though struck by a sudden pain.

It was as if a knife had cut into him, eliciting a pained gasp.

A doctor’s heart is as tender as a parent’s.

Sometimes, when a patient’s condition is severe, a sigh is all a doctor can muster.

“Doctor, is my wife really that sick? Lately, she’s only complained of heartburn and bloating—nothing else. Besides, we’re both farmers; we’re strong and rarely get sick.”

The man asked with a note of nervousness.

“The gastroscopy results aren’t promising; there could be a major issue,” Dr. Jia replied.

Dr. Jia shook his head and sighed.

“When did the heartburn and bloating start?”

“About two or three months ago. Sometimes, even when she’s very hungry, just a bite makes her feel full, and occasionally her stomach aches from the bloating,” the woman described her symptoms.

……

After a thorough examination and questioning, Dr. Jia looked over at Zhou Can.

“Zhou Can, what do you make of this?”

“From the gastroscopy and her symptoms, it looks like early-stage gastric cancer. If a biopsy confirms it, timely surgery should still be an option,” Zhou Can replied.

Zhou Can noted that there was significant overlap between Gastrointestinal Surgery and General Surgery.

As Tuyu Hospital has expanded, its departments have become increasingly specialized.

In the past, there wasn’t even a dedicated Gastrointestinal Surgery department.

Nearly all surgical cases were managed under General Surgery.

In recent years, a Gastrointestinal Surgery department was established primarily to handle gastrointestinal cases.

Depending on future needs, a Hepatobiliary Surgery Department might be formed.

In short, for a hospital to develop a new department, it must apply to the Health Bureau for approval and, most importantly, have renowned experts to lead it.

Take Dr. Jia, for example—he’s already retired, yet the hospital rehires him like a prized asset.

Not for any other reason but because he practically holds up half of the Gastrointestinal Surgery department.

Tuyu Hospital has plenty of general doctors, but true specialists are scarce.

That’s why, even though Zhou Can only holds a bachelor’s degree, his potential has been nurtured far beyond that of ordinary masters or doctors.

Those people can become the backbone of various departments.

A super genius like Zhou Can might even come to dominate the department.

There’s an old saying that while armies are common, a great general is hard to find.

Zhou Can is a born leader, and how could the hospital not invest in him?

“Did they also suspect gastric cancer? After reviewing her tests, the local People’s Hospital doctors advised a biopsy, worried about a malignant condition. Not trusting the small hospital’s capabilities, we rushed here to Tuyu Hospital.”

Women just can’t keep things to themselves.

They tend to let everything slip out.

“I recommend a biopsy as well. If it’s confirmed, she should be hospitalized immediately for surgery. Delay is not an option; metastasis would make it far harder to treat.”

Dr. Jia spoke with unwavering seriousness.

After years of practice, he had seen too many patients lose their chance at surgery due to delays.

“How much is the treatment? If it’s too expensive, I won’t go through with it. My son isn’t married yet, and at my age, I shouldn’t burden the family.”

The woman, though in her forties—in an era when people often live past eighty—should be in the prime of life.

It’s hard to comprehend that she would think this way.

A woman, once married into her husband’s family, is expected not only to manage all the household chores but also to labor in the fields and bear children for them.

Now, facing a severe illness, her first worry is that exhausting their funds might jeopardize her son’s prospects of finding a wife.

Zhou Can truly sympathized with the hardships women face.

His gaze fell upon the husband, who hesitated briefly before saying, “A Fen, let’s hear what the doctor has to say first.”

Goodness, that man is so cold and selfish.

It was painfully clear—if the treatment wasn’t too expensive, he would have his wife treated; but if the cost was exorbitant, he’d likely start preparing for the worst.

This was raw human nature.

“Right now, treatment costs are hard to pin down. On the lower end, just over 20,000 might suffice—even if it goes higher, because it was caught early, it shouldn’t exceed 100,000.”

Dr. Jia, ever perceptive, had clearly caught on to the man’s unspoken sentiments.

So he made every effort to quote the lower figure.

When surgery becomes necessary, even if the man grumbles, he will have no choice but to scrape together the money.

Doctors often do everything within their power to uphold fairness and justice.

“We can manage 20,000!”

At the sound of just 20,000, the woman beamed as if reborn.

“Honey, do you think that’s enough?”

In most households, financial matters are controlled by the man.

She sought his opinion.

“20,000 isn’t too bad—it’s about the value of two oxen. Doctor, can’t you lower the price a bit more?”

The man haggled as if he were at a marketplace, bargaining with the doctor.

Dr. Jia and the others could only shake their heads in amused disbelief.

“The treatment costs are fixed by strict standards set by higher authorities, not by us. Besides, with your New Rural Cooperative Medical Scheme, you’re eligible for significant reimbursement.”

Qiu Hong, a compassionate woman, stepped in to support the female patient, urging the husband to agree to treatment for his wife.

“Once my health improves, I promise to work hard and earn back whatever money we spend on this treatment,” the woman reassured her husband.

Her sweet words held the hope of a fresh start.

After all, when life hangs by a thread, who would willingly give up?

Zhou Can felt deep sympathy for her.

Married to a man devoid of compassion.

“Alright, then we’ll treat you! Honestly, I don’t know how it happened—others’ wives are fine, so why you?”

The man complained, his tone laced with grievance.

His words shattered Zhou Can’s once-ideal image of the kind, humble farmer.

Once the husband consented, the woman’s smile widened with relief.

She no longer cared about being belittled by him;

it was something she had grown used to.

In many remote rural areas, a woman’s status remains dismally low. Rigid traditional values that favor men are still deeply entrenched.

In some villages, if a woman fails to bear a son, she might be abandoned outright.

Dr. Jia issued a biopsy order for the woman, and the couple left.

“What kind of man is that? It infuriates me to just watch him,” someone remarked.

After the couple departed, Qiu Hong couldn’t help but scold,

“This case is actually one of the better ones—I’ve seen even more callous situations! There was a woman with cancer whose husband left without a backward glance.”

Dr. Jia, seasoned by experience, said, “As long as they return for the biopsy, this woman will have a chance. Otherwise, she’s in deep trouble. That’s why, ladies, you must be financially independent—never rely on anyone else.”

His parting words were a clear lesson for Qiu Hong.

“I always knew men are unreliable, which is why I fought hard to get into university. When my family wanted me to come back and get married, I refused.”

She was probably nearing her thirties by now.

She was beautiful, but beauty fades; at her age, it’s time to think about settling down.