Chinese Medicine: Starting with Daily Intelligence

Chapter 586: Chapter 586: A Professional Question

Li Xu went to find Hu Qiming again.

"Li Xu—no, I mean, Dean Li."

Upon hearing this, Hu Qiming was so excited he nearly jumped. "Hell yeah, of course I’ll go! As long as you don’t mind me being slow, I’ll follow you for life."

’This kid is pretty straightforward.’

Soon, the news of Li Xu’s promotion to Vice Dean blew up in their old class group chat.

Miaoli: "Holy crap, Li Xu is so badass! A Vice Dean at his age? He’s practically rocketing up the ranks."

Jiang Peng: "It’s well-deserved. With Li Xu’s medical skills, he could even be the Dean, no problem."

Li Baojie: "I’m so jealous! Does this mean we can pull some strings if we need to see a doctor at the Hospital of Traditional Chinese Medicine in the future? Haha!"

...

Although he had Hu Qiming and a few other young doctors as his core team, Li Xu knew it wasn’t enough to truly conquer the oncology department, a tough nut to crack.

He needed an expert with profound achievements in the field of Western oncology who could command respect and keep things under control.

However, given the current platform and strength of the City Hospital of Traditional Chinese Medicine, poaching a heavy hitter like that was next to impossible.

"No rush. One step at a time," Li Xu told himself. ’To deal with external threats, I must first get my own house in order.’

That afternoon, Li Xu convened a meeting with all the doctors from the oncology department.

The atmosphere in the conference room was a bit delicate.

The original head of the oncology department, Luo Xiangnan, was a bald man in his fifties. He wore thick glasses and had a somewhat rigid appearance.

He had held the position for over a decade. While he had no major achievements, he had made no major mistakes either. Above all, he was a veteran.

Luo Xiangnan was thoroughly unconvinced by Li Xu, this young Vice Dean who had been parachuted in to become his direct superior.

’On what grounds?’

’Just because you can read a pulse?’

’Just because you can write a few traditional Chinese medicine prescriptions?’

’This is the oncology department!’

’The domain of Western medicine!’

’What business does a TCM doctor have coming in here and giving orders?’

The meeting began. Li Xu started with a few simple words about the concepts of integrating traditional Chinese and Western medicine, as well as cancer prevention and intervention.

Luo Xiangnan sat below, a cold expression on his face, twirling a pen in his hand and letting out a soft scoff from time to time.

When Li Xu finished speaking,

Luo Xiangnan suddenly spoke up, his tone clearly provocative:

"Vice Dean Li, we all admire your skill in traditional Chinese medicine, and I admit that TCM has its merits in regulating the body. However, when it comes to treating tumors, especially solid malignant ones, relying solely on TCM theories is probably not viable."

"After all, patients these days want to see results. They want to see if the tumor has shrunk. Just drinking herbal decoctions is too slow."

"Are you familiar with the mainstream technologies in modern oncology? For example—the Hifu Knife?"

This was clearly a move to put Li Xu in his place.

He assumed that a TCM doctor like Li Xu would know nothing about such sophisticated Western medical equipment.

To his surprise, Li Xu just smiled and said calmly, "I know a thing or two. The Hifu Knife, or High-Intensity Focused Ultrasound, uses the penetrative and focusing properties of ultrasound waves to create high temperatures in a target area within the body, causing coagulative necrosis of the tumor. It’s quite effective for liver cancer, pancreatic cancer, uterine fibroids, and so on."

Luo Xiangnan was stunned. He hadn’t expected Li Xu to be so accurate.

But he didn’t give up. Instead, he threw out a more professional and tricky question, trying to stump Li Xu with technical details.

"Dean Li, I didn’t expect you to be so knowledgeable about conceptual things like the Hifu Knife and SBRT."

Luo Xiangnan pushed up his glasses. "I have a question about clinical practice I’d like to ask you."

"SBRT technology allows for high-dose, precise radiation to the target area, but the tumor’s position shifts due to respiratory motion. What is your understanding of ’respiratory gating’ technology?"

"Also, regarding anesthesia for the Hifu Knife. When treating deep tumors like liver or pancreatic cancer, we usually use general anesthesia to prevent the patient from moving due to pain."

"However..." Luo Xiangnan’s tone shifted. "In gynecology, when treating uterine fibroids or adenomyosis, we often avoid general anesthesia in order to monitor the patient’s reactions and prevent nerve damage. We use only sedation and analgesia."

"This presents a huge conflict: if the dosage is too low, the patient moves from the pain, causing the focal point to shift and the procedure to fail. If the dosage is too high, the patient is completely unconscious, and if a nerve is burned, she won’t react, which could lead to paralysis."

"This requires an extremely delicate state of ’conscious sedation.’ The patient must remain awake enough to follow commands, yet feel no pain."

"So, my question for you, Dean Li, is this: if it were you, how would you use drug ratios and operational techniques to precisely control this balance?"

At that, the entire conference room fell silent.

The other doctors in the oncology department all looked at Li Xu, their eyes filled with sympathy.

This was an extremely professional question about the coordination between anesthesia and procedure—knowledge gained by countless clinicians through hands-on experience on the operating table. One could even call it a "trade secret."

This was on a completely different dimension from the TCM practices of observation, listening, questioning, and pulse-taking.

Sitting next to Li Xu, Hu Qiming’s palms were sweating.

’It’s over.’

’He couldn’t even understand the question.’

’Li Xu is brilliant, but he’s a bona fide TCM doctor.’

’How could he possibly answer something purely from Western medicine?’

’This is a blatant attempt by Luo Xiangnan to assert his dominance!’

If Li Xu couldn’t answer, or if his answer sounded like a layman’s, his credibility as Vice Dean would be shattered before it was even established. Any future reforms would be impossible; no one would listen to him.

Li Xu looked at Luo Xiangnan’s aggressive gaze and inwardly chuckled.

’If this were yesterday, I might have actually been stumped.’

’But recently, the information provided by the system has been like a steady stream, covering not only advanced Hifu Knife operations but also delving into all aspects of oncology, even including knowledge from many related disciplines.’

His move to take over the oncology department was no whim; he had a solid plan.

"Director Luo has raised a very professional question."

Li Xu’s voice was steady. "Whether it’s the Hifu Knife or SBRT—Stereotactic Body Radiation Therapy—the core difficulty does indeed lie in the conflict between precise targeting and patient cooperation."

"The current mainstream solution relies on fully digitized, real-time control through five major systems: IGRT (Image-Guided Radiation Therapy), TPS (Treatment Planning System), TMS (Tumor Motion Management System), Linac (Linear Accelerator), and QA (Quality Assurance). Together, they form a closed loop to minimize error."

Luo Xiangnan raised an eyebrow slightly, surprised that Li Xu could casually list these professional terms with such clear logic.

Li Xu then changed the subject. "However, the equipment is inanimate; it’s the people who are alive. I just looked at the oncology department’s surgical schedule for tomorrow. If I’m not mistaken, there’s a stereotactic lesioning procedure for Parkinson’s disease, correct?"

Luo Xiangnan was taken aback, then nodded. "Yes. The patient is a 70-year-old man with severe tremors. Medication is no longer effective."

"The key to this surgery is to precisely ablate the ventral intermediate nucleus of the thalamus."

"To ensure the target is accurate and avoid damaging the surrounding language and motor function areas, the patient must remain awake during the procedure to cooperate with the doctor’s tests of speech and limb movement."

"However..."

"The current difficulty is... if we use local anesthesia, the patient’s fear and pain make it difficult to cooperate fully. Their agitation could even cause localization errors. But if we use general anesthesia, the patient is unconscious and can’t cooperate with the tests, making the surgical outcome a matter of pure luck."

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