Chen Junnan found the conversation rather unsettling: "Why does this sound so unscrupulous? We perform surgeries hoping to save lives, while you father and daughter are here wishing for people's deaths."
Ai San took offense: "What do you mean 'unscrupulous'? If the person survives, you save a life and gain immeasurable merit by building a Seven-level Pagoda. If they don't make it, we give them a dignified send-off with a grand funeral procession, which is also immeasurable merit. How can that be called unscrupulous? This is hedging. Understand economics? Even America's Buffett says so - in business, bet on both sides and you won't lose. When the deceased is sent off with dignity, doesn't that comfort the family? Once the erhu starts playing and the suona blows, let me tell you, there's no one the erhu can't make cry, no soul the suona can't see off. When the atmosphere is right, the weeping becomes lively, allowing people to cry out their bitterness, release half a lifetime of pent-up frustrations, and wail away a lifetime of sorrows. The dead are gone, but what about the living? After crying and wiping their tears, the family members can still function normally and carry on with life. This is the virtue of our profession, understand?"
People like Ai San could only see the surface - a young girl hit by a truck, bleeding inside her skull, looking like she wouldn't make it. But Liu Zhengliang and the others knew that since the child was brought in early, performing intracranial decompression surgery promptly to remove the hematoma still gave her a twenty percent chance of survival. When the critical condition notice came down, Ai Chen stood facing the little girl's mother. With just one look from Ai Chen, Ai San went out to make arrangements.
An encoffining master must know how to suture. Since this child died in a traffic accident, she probably had several broken ribs - they needed to find someone skilled to handle the preparation. They couldn't use wire for the inner support, or else during cremation there'd be a bunch of steel wool in the ashes, which wouldn't be respectful. They had to use bamboo strips to secure and support the burial garments so they wouldn't collapse.
Ai Chen had calculated this job several times on her phone calculator. Following the most economical approach for the family, it would cost at least thirty thousand yuan, or forty thousand for a slightly more dignified arrangement.
The surgery began with maintaining mechanical ventilation for the patient - the child could no longer breathe on her own. They made a full-thickness scalp incision and reflected it back to expose the skull. At this point, they could see the patient's frontal bone had a fracture flap with radiating fracture lines extending outward.
Che Mingming said: "There's cerebrospinal fluid reflux from the skull base too."
Liu Zhengliang responded: "Irrigate with saline solution containing gentamicin."
Using a bone nibbler, Liu Zhengliang removed a piece of the patient's cranial bone flap, creating a window. While operating, he explained to Che Mingming: "The patient has an intracranial hematoma, estimated at least 90 milliliters, with midline shift of 12 millimeters. The mortality rate in such cases never falls below 80%. We need rapid dehydration - can't let the hematoma persist. Administer 250ml of 20% mannitol intravenously, drip rate 160."
The nurse prepared the injection nearby.
Che Mingming performed a tracheotomy on the little girl to ensure the non-breathing patient wouldn't choke on phlegm. After completing the tracheotomy, he connected the ventilator. Liu Zhengliang handled the large bone flap. The nurse then reported: "ICP is still too high."
Without looking up, Liu Zhengliang requested mannitol, furosemide, and dopamine, asking Chen Junnan to bring them immediately.
Upon receiving the call, Chen Junnan rushed out of the emergency hall, went straight to the emergency pharmacy, then ran to the operating room. There was no time for sterilization - he could only hand the medications to the nurse at the operating room entrance.The little girl's father asked Chen Junnan, "How is it, doctor?"
Chen Junnan replied, "The ICP is too high."
The father asked, "What's ICP?"
Chen Junnan answered, "It means intracranial pressure. The pressure inside the child's brain is too high now. After being hit by the car, there's a hematoma in her brain, which increased the pressure. It's already 5.33 kilopascals now. Let me tell you, brother, you need to be mentally prepared. If you don't believe me, you can check online. The surgical data parameters are all recorded now. With your child's condition, if you search these parameters online, you'll find that those who survive worldwide can be counted."
The father crouched there, nodding repeatedly, "If she really can't be saved, then it's her fate. So what will the doctors do next?"
Chen Junnan said, "The doctor inside, Dr. Liu, will use a miniature vacuum to suction out the hematoma from the child's brain. We need to get through this critical point first. Every barrier is tough, but we'll overcome each one. Brother, don't lose hope yourself."
Liu Zhengliang removed the large bone flap from the patient's skull, and the intracranial pressure immediately dropped significantly. He then said, "Estimated blood loss is 500 milliliters, transfusion of 400. Next, we'll proceed with hematoma evacuation and brain contusion debridement."
Liu Zhengliang held the suction tip, carefully adjusting the negative pressure while dealing with the hematoma. He picked up the bipolar electrocoagulation and began debridement: "With the intracranial pressure down, the probability of vital organ failure is much lower. It's been over a year since I last handled this bipolar electrocoagulation. People always find ways to overcome obstacles. In the early days, we used monopolar electrocoagulation, but it couldn't be used on major arteries or in the brain initially. Each discharge would pass through the patient's entire body, with too much current, risking electrocution of brain tissue. Later, scientists figured out a solution - using two tips so the current passes only between them, allowing both cutting and hemostasis."
Che Mingming responded, "Did you suddenly get to handle it again, like reuniting with an old lover?"
Liu Zhengliang worked while saying, "Hey, I rarely had chances to use it before. I specialize in interventional procedures and don't need this. Let me ask you, since this electrocautery combines cutting and coagulation, do you know how it works?"
Che Mingming said, "Who are you asking? I'm not an electrician."
Liu Zhengliang told Che Mingming, "Actually, it's quite simple - both involve electrical discharge. One uses more discharge to vaporize tissue, functioning as a knife; the other uses less discharge to cook the tissue, achieving hemostasis. One uses high-frequency discharge, the other low-frequency. Water can carry a boat, but can also overturn it."
Che Mingming prepared the biological membrane and handed it to Liu Zhengliang for suturing, smiling as he said, "Are you going to share some life philosophy now?"
Without looking up, Liu Zhengliang said, "As long as there's electricity, I can do whatever needs to be done. That's the wisdom of electrocautery."
Several hours later, the operating room doors opened, and several doctors emerged. The little girl's father immediately rushed up to ask. Liu Zhengliang, looking somewhat relieved, said, "The brain herniation has been alleviated for now. The next few days will be the most critical. We can only do our best and leave the rest to fate. But there's hope - don't lose heart. The child is young and will definitely pull through."If it weren't a phone in her hand instead of a calculator, Ai Chen would have thrown whatever she was holding to the ground in frustration. When had she ever misjudged a person's fate? Just by watching how the ambulance braked when entering the hospital, she could tell what was wrong; by seeing whether the nurse or the doctor stepped out first, she knew if the person could be saved.
Liu Zhengliang noticed Ai Chen's gloomy expression nearby and couldn't resist walking over to tease her, asking, "Lost the job?"
Ai Chen ignored her and walked a good distance away to call her father.
At that moment, Ai San was at the crematorium, attending another funeral. In the winter of Northeast China, especially around the winter solstice, the days were the shortest, with the sun rising after 8 a.m. and setting around 4 p.m.—even earlier than in Beijing due to the time zone. This was why people said the yin energy was strong then, making it easier to send off the elderly. In reality, it was just the cold weather and the sharp temperature difference between indoors and outdoors. You'd be warm inside, but as soon as you stepped out, the cold air would shock your system, tightening your skin and blood vessels, causing blood pressure to spike suddenly. A blood clot might dislodge and travel—if it lodged in the brain, it caused a cerebral embolism; if in the lungs, a pulmonary embolism. If treatment failed, the person was gone. The old man Ai San was sending off now was exactly such a case. When Ai Chen called, Ai San was still reciting the ritual verses:
"Open the eyes to see all directions.
Open the ears to hear all sounds.
Open the nose to smell the grains.
Open the mouth to eat pork, beef, and mutton.
Open the heart to shine brightly.
Open the left hand to grasp wealth and grain.
Open the right hand to write essays.
Open the left foot to walk the world.
Open the right foot to step on the lotus to the Western Paradise.
Pillow the jacket for generations of goodness.
Tread the pants for descendants' prosperity.
Horse in front, sedan behind, the Filial Son and Virtuous Grandson stand on either side;
The elder has passed away, riding the crane to the afterlife."
After the recitation, the body was pushed into the furnace, marking the end of this life. When it emerged, all organic matter was gone, leaving only inorganic remains. If the lid wasn't secured properly, even those could be blown away by the wind. If there were gold teeth, the family had to be reminded. When collecting the ashes, some would even crush the bones searching for gold, as if they weren't dealing with their own father—perhaps a miner's instinct, treating the ashes like panning for gold.
Ai San only found time to return Ai Chen's call during a cigarette break. Upon hearing the person had been saved, he immediately called the Shenyang embalmer, saying, "Buddy, no need to come anymore."
The embalmer was furious: "I've driven all the way to your doorstep, and you're messing with me?"
Ai San had no choice but to apologize, and after much persuasion, he paid the man a thousand yuan to send him off.
Meanwhile, Ai Chen walked into Liu Zhengliang's office and saw her still writing the medical record for the little girl. She teased Liu Zhengliang, "Dr. Liu, looks like you're planning to cut off my business in the ER of Second Hospital, huh? That little girl was smashed up so badly, her brains were out, and you still managed to bring her back. Pretty impressive."
Liu Zhengliang kept her eyes on the computer, smiling without a word.Ai Chen had quite a favorable impression of Liu Zhengliang. The men she encountered daily were all under her father's wing – some were ex-convicts released after serving sentences for brawling, others were out on medical parole for fraud charges, sporting thick gold chains and watches while enjoying barbecue three times a day. Ai San had also tried setting her up with matches – either tax bureau or industry and commerce bureau employees earning three to four thousand a month, all carrying that distinctive small-town civil servant superiority complex. During blind dates, they'd act reluctantly, only showing up because Ai Chen was attractive – otherwise these meetings would've been pointless. One tax bureau guy once mentioned how his career needed advancement, saying he couldn't remain a tax collector forever and hoped Ai Chen could help him meet quotas. Ai Chen found this amusing, thinking he was just trying to boost his performance metrics, while mentally noting his salary couldn't even cover one of her handbags. She wanted someone smarter than herself – acknowledging her own lack of cleverness, she felt life would be dull paired with a simple-minded man. Liu Zhengliang struck her as interesting, appearing bookish yet possessing stubborn determination. Fushun women prefer men with character – what's character? It's the conviction to persevere through challenges. Of course, this standard isn't easily quantifiable; sometimes you might misjudge and end up with someone who beats his wife after two drinks. Many abused women still endure such marriages, considering it a sign of their husband's decisiveness and backbone.
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