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Or rather, the lack of any department can be quite problematic.

At this moment, Xiao He encountered just such a problem!

Old Yang was a long-term patient of Xiao He’s as well as a fellow villager, having been under Xiao He’s care for over a decade. In 2007, due to his spouse experiencing rectal bleeding, they came for a colonoscopy, and at the urging of his son, Little Yang, Old Yang—out of curiosity—also underwent a gastroscopy.

But what they didn’t expect was the discovery of a polyp during the check-up, which after a pathological examination, turned out to be gastric cancer!

This was a huge blow to an already impoverished family.

Once diagnosed, treatment was necessary. The family went all in, spending over a hundred thousand in the capital for surgery, and the constant medication further strained Old Yang’s finances to the brink of collapse.

The silver lining was that the money was gone, but the person was still there.

Xiao He remembered a conversation with an oncologist, discussing the most distressing thing one could encounter.

Oncologist Yang Xi said, “The most painful thing about coming to the hospital is losing all your money without saving the person.”

Old Yang was rather lucky; the tumor was detected early, treated early, and thus, he recovered early.

However, this ordeal terrified the family, prompting them to periodically get gastroscopies done.

Despite Xiao He’s repeated reassurance, there was no dissuading them.

Old Yang’s family wasn’t affluent. His son, Little Yang, worked in Aneyang, and his daughter-in-law was a restaurant waitress. Both parents lived in the village, helping with the grandchildren.

Little Yang was dutiful, regularly bringing his father to the provincial hospital for gastroscopy and thorough examination, an expense that was significant each visit, yet his daughter-in-law never complained. No matter what, theirs was a harmonious home.

Over time, the family grew closer to Xiao He. At each visit, Xiao He personally conducted the gastroscopy, and they had nearly become friends.

Since Xiao He and Old Yang were from the same hometown, Xiao He never put on airs; each time Old Yang came for treatment, he would bring some beans, corn, potatoes, sweet potatoes, millet, and the like from his fields.

This time was no different. Upon arrival, Old Yang greeted Xiao He, “Director Xiao, I’ve been feeling some discomfort here lately. Eating hard things causes unbearable pain. Can you check what’s wrong?”

Most people undergoing gastroscopy were inpatients seeking reimbursement. Old Yang’s rural medical insurance had a low reimbursement rate of only fifty to sixty percent at the provincial hospital in Aneyang. Instead of spending a fortune on hospitalization, it was more economical to come directly to Xiao He for the examination, which cost just a few hundred yuan.

Old Yang was quite accustomed to gastroscopy and came well-prepared on an empty stomach to see Xiao He.

Old Yang said, “Recently, I’ve been feeling a burning pain after eating, and lately, I dare not eat solids, only drink porridge.”

To save money, Old Yang opted for the painful gastroscopy but had grown accustomed to it. As the scope slowly moved, Old Yang endured the pain.

He noticed the pain was more intense than usual!

Old Yang didn’t think much of it, perhaps it was just inflammation?

As Xiao He was advancing the endoscopic probe deeper into the esophagus, he suddenly felt Old Yang’s body jerk.

“Old Yang, bear with it and don’t move,” Xiao He urged.

Painless gastroscopy was not dangerous, and the pain wasn’t intense; it was mainly discomfort, which was quite distressing. However, as Old Yang underwent it every year, his tolerance was strong.

This made Old Yang stay still.

Yet, as Xiao He delved further with the probe, Old Yang suddenly felt a surge of intense pain!

His body involuntarily twisted in reaction.

Under normal circumstances, this wouldn’t be frightening—after all, the probe was soft, not so different from a plastic tube, fine, long, and flexible.

At most, it was somewhat uncomfortable.

However, at the moment of Old Yang’s twist, the probe collided with the wall of the esophagus.

Xiao He suddenly felt a sense of emptiness!

Instantly, Xiao He’s expression changed!

This was trouble!

Perforation?

A tear?

And Old Yang was in so much pain, he was almost screaming “ah ah ah,” had the people around him not held him down, he might have rolled onto the floor.

The nurse conducting the examination quickly pressed down on him!

Xiao He’s face changed color, knowing the procedure could not continue at this point; the probe must be removed quickly, or based on this situation, there would surely be complications. He urgently called out, “A few people, come help me hold the patient down.”

A few doctors and nurses from the endoscopy room hurried over.

Old Yang’s face was contorted with pain, and his features almost twisted together.

Could this not hurt?

The esophagus had been pierced through; of course it was excruciating!

Xiao He had a serious expression. Was the wall of the esophagus made of paper that it could be so fragile?

The endoscopy room wasn’t a set of small rooms, but one large room, where each instrument was separated by a curtain for privacy, similar to window curtains.

After several doctors and nurses arrived, Xiao He quickly instructed, “Hold the patient down, and remember, absolutely do not let his head move!”

“Old Yang, bear with it, don’t move around, otherwise it could lead to problems!”

Startled, Old Yang, despite the pain, endured it, forcefully closing his eyes— but the pain felt like it was boring into his heart. With a mouth guard in place, his mouth couldn’t move, so tears could only stream down his face.

This was truly pain that brought tears to one’s eyes!

At that moment, everyone saw on the endoscope monitor a hole had appeared in the esophagus!

Everyone was shocked!

This was just an endoscope probe, not a trident; how could it puncture through the thick wall of the esophagus?

No wonder Director Xiao was getting nervous.

With this thought, everyone looked at Xiao He with a grave expression.

At this time, a speedy transfer to another hospital for surgery was needed…

After all, everyone knew the state of the Second Provincial Hospital— such surgery was simply not possible there, and this realization even made everyone feel sorrowful, for a hospital without the necessary backup departments truly left doctors feeling powerless.

The department’s doctors watched as Xiao He carefully and cautiously retracted the probe.

Old Yang lay on the bed, turned over, lay prone, with his hands cupped in front of his chest, and then moved into a kneeling position.

Deputy Director Hou Xu of the department looked at Xiao He, “Director… shall we contact another hospital for a transfer in time?”

Xiao He frowned; transferring was the only option!

After all, the hospital was not capable of performing a thoracic esophageal perforation repair.

After hesitating for a while, Xiao He said, “Go call Old Yang’s family in, and everyone else, go about your tasks, disperse.”

The nurse quickly got up and rushed out.

Soon after, Young Yang and his mother walked in.

Xiao He looked at the two, sighed, and said slowly, “There was a complication with Old Yang’s endoscopy.”

Old Yang’s daughter-in-law shivered, her voice trembling as she asked, “Director Xiao… what happened? Did you find another illness?”

Xiao He shook his head, “No, we haven’t discovered another illness. This time… it’s a perforation in Old Yang’s esophagus.”

Both were puzzled, not understanding what it meant.

“What does this mean? Director Xiao… what do we need to do?”

“Are you afraid of an esophageal perforation?”