Xiao Cheng Liang Fang

This round of bureaucratic buck-passing drove Lao Duan mad.

From then on, wherever Lao Duan went, she carried a box of chalk. On every cement wall, stone pillar, and blackboard in Fushun—any surface that could bear chalk marks—she would scribble her doggerel verses, furiously denouncing the general manager. The police confronted her several times and even detained her twice, but after each release, Lao Duan resumed her writing. Detention proved utterly useless: after the first stint, she began composing poems to curse the district mayor; after the second, she escalated to lambasting the city mayor. The municipal officials realized they couldn’t arrest her again—each detention only prompted her to target higher authorities.

Her verses ranged from parallel prose to quatrains and regulated poems, disregarding tonal precision but delivering scathing insults with unrestrained fervor. When the mayor built a useless overpass that drivers avoided in winter for fear of icy, slippery surfaces, she wrote: "xxx is a damn fool, built a giant slide; with so few cars in Fushun, how much more must our suffering abide?"

The old woman kept writing like this for over a decade, leaving her mark on virtually every wall in Fushun, using no fewer than twenty thousand sticks of chalk. Back when Liu Zhengliang was in school, people would often gather by the walls where Lao Duan had written, reciting her poems aloud. When she noticed a crowd, Lao Duan would even deliver impromptu speeches. Over time, however, public indifference grew. No one cared anymore what she wrote, and few even remembered why she had become this way or what injustice had driven her to it.

By 2015, Fushun’s officials had fallen from power "one after another," enough to fill two mahjong tables. Lao Duan finally stopped writing. Her epic, longer than Homer’s Iliad and Odyssey combined, had run its course. She didn’t know the new officials and had no one left to curse. As the youth gradually moved away and the elderly grew numb, some began to wonder: had Lao Duan died?

A decade after this street-level political commentator vanished, she reappeared before Liu Zhengliang, her hair now silver, her face aged beyond recognition. This once-famous street poet of Fushun—the kind of angry voice found in every Chinese city—now sat in a wheelchair, gaunt and swollen. Lao Duan’s son said to Liu Zhengliang, "Doctor, my mom’s lower abdomen hurts with any movement. Look, her body is swollen, and she’s had trouble urinating lately. She hasn’t slept for three days—just can’t fall asleep. Can you check what’s wrong?"

Liu Zhengliang replied, "She needs a full examination. I can’t say without one."

Lao Duan’s son explained, "We saw a traditional Chinese doctor who said it’s Yin Fire, an internal heat imbalance. He prescribed Shuanghuanglian, but after several days, it hasn’t helped."

Che Mingming remarked coldly from the side, "Shuanghuanglian again. That stuff works wonders. I knew a relative of a classmate who was cremated, and after an old TCM doctor poured two bottles of Shuanghuanglian on the grave, the guy jumped right out the next day."

Liu Zhengliang shot Che Mingming a glare, thinking to himself, Could you save the sarcasm for a better time?

Lao Duan’s son added, "Doctor, we only brought five hundred yuan. We really have no money."

How could they have any? His son had long been jobless, Lao Duan had spent over twenty years petitioning, her husband had passed away, and now the two of them survived solely on her meager pension.Lao Duan was quite displeased; she disliked her son speaking so submissively, but she was clearly gritting her teeth against the pain as she said, "If you can prescribe some medicine, just prescribe some. If it's too expensive, we won't bother with treatment."

Liu Zhengliang smiled apologetically and said, "Auntie, we need to run some tests first to determine the condition. Without any examination, if you ask me to diagnose just by looking, I wouldn't dare to confirm anything."

Lao Duan replied coldly, "We only have five hundred yuan. If that's not enough, let's just go back."

Lao Duan's son was caught in a dilemma. The two had argued on the way here, and if Lao Duan hadn't been in a wheelchair, she wouldn't have come to the hospital with him at all.

Liu Zhengliang couldn't bear it and said, "Auntie, how about this: whether you do other tests is up to you, but at the very least, you should get a blood test. It's cheap, just a few dozen yuan. With that, I can at least get an idea of your overall health."

The old lady remained silent, but her son immediately wheeled her off for the blood test. The results came back quickly: creatinine 914, uric acid 450.

Liu Zhengliang looked at the lab report and asked, "Auntie, how long have you been unable to urinate?"

Lao Duan replied, "It's been difficult to pee for the past month. Before that, my lower back always hurt. The pain in my lower back stopped two nights ago, and now it hurts here in my lower abdomen."

Liu Zhengliang said, "If it's only been two or three days, that's somewhat manageable. Auntie, you still need to take a urine test."

Lao Duan grew angry: "If I could pee, I wouldn't be here. We've already done the blood test. If you can treat me, then treat me. If not, we'll leave."

Che Mingming, who had been listening nearby, grew anxious: "Auntie, you shouldn't delay this. Your creatinine is over 900. High creatinine levels can't stay that way for long—it causes irreversible damage to your respiratory and circulatory systems. It could lead to hydronephrosis or even kidney failure. Delaying could cost you your life."

Lao Duan replied, "I'm almost eighty. If it's a quick end, that's just fine."

Liu Zhengliang said to Lao Duan, "Auntie, I suspect you have kidney stones. The earlier pain was from a stone stuck in the ureter, and now it's dropped into the urethra and gotten stuck there. Because it's blocked, urine can't leave your kidneys, which is why waste products like creatinine and uric acid are so high in your blood. Look, your lower abdomen is swollen—I suspect your bladder is full of urine. But this is just a guess. You can't have me diagnosing blindly. Listen to me: get an ultrasound so I can at least see that stone."

Lao Duan asked, "What if we do the ultrasound and there's no stone? Wouldn't that be a waste of money?"

Liu Zhengliang chuckled: "Auntie, this isn't like buying a watermelon with a guarantee it'll be sweet and ripe. But no problem—if there's no stone, I'll pay for the ultrasound. Go ahead and get it done."

Only then did the old lady reluctantly agree to the ultrasound. The results came back, and sure enough, an 18-millimeter stone was stuck in her urethra, unable to move up or down.

The old lady said, "Before, when I felt uncomfortable, I’d pat my lower back with an open palm, and it would feel better."

Che Mingming said, "Yes, and now it's all shaken down into the urethra. It's like a clogged drain—no matter how much you pat, it won't help."

Lao Duan asked, "So what can be done?"

Liu Zhengliang said, "You'll need to go to the urology department. We can't handle it here. They'll likely perform lithotripsy to break up the stone. Once it's shattered, drink plenty of water, and when you urinate, the fragments will pass out. Then you'll be fine."Liu Zhengliang called the urology department to explain the situation, only then did Lao Duan's son take him to urology. Shortly after, urologist Du Wei came directly to find Liu Zhengliang: "Dr. Liu, we can't perform lithotripsy directly in her condition. Her ultrasound shows ureteral injury, the stone is so large, there's severe hydronephrosis, and it's visibly stuck in the urethra. Who would dare perform lithotripsy? She needs to urinate first. This old lady is unreasonable - she came demanding I perform lithotripsy immediately, and when I admitted her for hospitalization she accused me of trying to cheat her money."

Liu Zhengliang said: "Then let her urinate first."

Du Wei said: "How? The stone is stuck there."

Liu Zhengliang said: "Just use a urinary catheter to push the stone back into the bladder."

Du Wei said: "I don't have that technique - if I push improperly it could cause infection. Besides, the problem is we don't have rigid urinary catheters - all of Fushun only has soft catheters. I just told the old lady, why not have surgery? It's such a simple procedure - minimally invasive, solved for fifteen thousand. She refused."

Liu Zhengliang asked: "What about the zebra guidewire? Use endoscopic laser lithotripsy."

Du Wei smiled wryly: "Our small hospital doesn't have that equipment either. She'd have to go to Shenyang for that."

Soon Lao Duan and her son returned. Lao Duan said: "Xiao Liu, I don't want surgery. I don't have that much money. Surgery would cost at least twenty thousand, and even after reimbursement it'd still be ten thousand. I'm living day to day - splitting one steamed bun between two meals. My son is over forty and still not married. I don't want to spend so much on treatment - I want to leave something for him.Liu Zhengliang sat there in a daze, this was indeed a difficult problem. If she had surgery, it would be very simple - just minimally invasive stone removal. But the old lady was stubborn, refusing both hospitalization and surgery.

Liu Zhengliang said: "Auntie, our hospital doesn't have urological guidewires. Why don't you go to Shenyang? They definitely have them there, along with endoscopes. That procedure is even simpler - they insert a small tube, use laser to break up the stone, then use a small basket to remove the fragments. No incision needed, it's the safest option."

Lao Duan said: "I'm not going. Going to Shenyang would mean hospitalization. Here in Fushun I can go home at night and save money."

Liu Zhengliang said: "Auntie, if you don't go to Shenyang and refuse surgery, this 'minor problem' could kill you in three to five days."

Lao Duan said: "So be it. I'm seventy-eight already - lived long enough."

Lao Duan's son objected: "Mom, it's just some money. Let's have the surgery."

Lao Duan said: "We only have twenty thousand total in the house. If I spend it all on treatment, how long would it take me to save that much again with my pension? Besides, if I have surgery, who will take care of me? Can I count on you to handle my bedpan? I can't rely on anyone - the old ones waiting to die their whole lives, the young ones doing the same."

Che Mingming, who had been watching nearby, couldn't take it anymore but had no solution, so she kicked Liu Zhengliang's chair.

Liu Zhengliang looked around and suddenly had an inspiration: "Mingming, go to the anesthesiology department and get a central venous catheter guidewire. We may not have urological guidewires, but we definitely have internal medicine guidewires."

Che Mingming didn't understand: "What do you need a vascular guidewire for? She doesn't have a hemangioma."

Liu Zhengliang explained: "We'll use the guidewire to push the stone back into the bladder first, then insert the soft urinary catheter. This way even a soft catheter can be inserted."Che Mingming said, "Stop overthinking it. The Health Commission has issued a directive—central venous catheter guidewires can't be used for anything else, only for their intended purpose. Besides, central venous catheter guidewires aren't cheap either. Would you spend over a thousand yuan just to poke at a stone? What a waste."

Liu Zhengliang stood there stunned, rubbing his face repeatedly with both hands. The problem was too difficult. The stone was stuck in the lower urethra, the bladder had swollen into a ball, and there was fluid buildup in the kidneys. If this continued, the old lady's kidney would be ruined.

Suddenly, he had a flash of inspiration. Without saying a word to Che Mingming, he went straight to fetch a throat swab.

A throat swab is essentially a long cotton-tipped stick, typically used for throat testing, resembling an extra-long cotton swab.