Liu Zhengliang said to Che Mingming, "Use this to push the stone back. Go prepare some lidocaine, 5 milliliters, for direct urethral injection. Once the anesthesia takes effect in about half an hour, I'll use a throat swab to push the stone back."
Che Mingming looked skeptical. "Will this actually work?"
Liu Zhengliang then turned to Lao Duan's son. "Once we push the stone back into the bladder and insert the urinary catheter, make sure the elderly lady drinks plenty of water and urinates frequently to quickly lower her creatinine and uric acid levels. If this drags on any longer, her cardiopulmonary function could fail. The stone isn't urgent—we'll perform extracorporeal lithotripsy after the urinary tract infection improves and the fluid retention is fully drained."
He then said to Lao Duan, "Auntie, you'll definitely need to spend some money. Five hundred yuan won't be enough—extracorporeal lithotripsy alone costs at least over a thousand. Plus, you'll need anti-inflammatory medication. Just follow the hospital treatment properly. It'll only take three or four days, and at most, it'll cost two thousand yuan. After reimbursement, you'll only pay about a thousand yourself. Is that acceptable? Even if I push the stone back with this throat swab, you mustn't move around recklessly. If it gets stuck again, don't try to save money—just stay for treatment."
Lao Duan sat in her wheelchair without speaking.
Che Mingming said, "That's right, Auntie. When you're sick, you need treatment. Come on, I'll accompany your son to handle the paperwork."
The method was simple, but if you actually had a stone and went to the hospital asking a doctor to do this, they'd surely kick you out. This was an emergency workaround, and Liu Zhengliang wouldn't have done it for just anyone. Without needing an endoscope, laser lithotripsy, or contrast imaging—since the stone's position was confirmed in the scan—Liu Zhengliang pushed the stone back into the bladder in just ten minutes. Che Mingming comforted Lao Duan, "Auntie, we won't charge you for this throat swab—it's just a cotton swab, not worth much. But please don't mention this to anyone outside. He only used this unconventional method because you're such a stubborn old lady."
While washing his hands, Liu Zhengliang told Che Mingming, "Later, wheel the aunt to bed and take her to the urology department so they can insert the urinary catheter."
The urinary catheter was then inserted. Urine started flowing immediately, filling a bag in less than five minutes, requiring a replacement. The catheter tip had a small balloon that inflated once inside the bladder, securing it at the lower end so daily activities wouldn't be affected—walking or sitting as needed. Liu Zhengliang instructed Lao Duan's son, "Your mother still needs hospitalization for observation while draining urine. Over the next few days, discreetly take her to the nephrology department for more tests. Since you're at the hospital, resolve all the issues so you, as her son, won't have lingering concerns."
Che Mingming felt like he'd learned a lesson from Liu Zhengliang and asked him, "Why are you so attentive to this old lady? Logically, you could've just sent her away—she's so stubborn. What if the throat swab accidentally caused a urinary tract infection? That'd just bring more trouble. This old lady is quite notorious—if you offend her, she might write poems on the walls cursing you every day, and you'd be in deep trouble."Liu Zhengliang said: "You don't know this, but my mother was laid off from the machinery factory. Though stubborn and difficult to get along with when she was young, she was genuinely good-hearted. Many workers still remember her kindness to this day. The old lady can't break out of her mindset - the principles she believed in her whole life suddenly stopped working, so her thinking got stuck in the 1990s. She's convinced all officials are corrupt and all doctors are out to fleece patients - it's become a fixed pattern in her mind. Back when their whole factory was queuing for housing assignments, she insisted on waiting until all intermediate-level workers got their apartments before taking hers. No airs of authority, never hogged benefits, always answered the call her entire life. But later, the world became too unfair in her eyes. We need to give her some fairness and justice, as much as we can. Even if her faith has collapsed, if I can add one brick to rebuild it, that's something. If I don't take care of her, she'd really go home and wait to die - I can't bear that thought alone."
That night, Lao Duan's son kept feeding her water and repeatedly emptying the collected urine. The two-liter drainage bag - Lao Duan's son emptied it twelve times throughout the night. The old lady had full-body edema in the morning, leaving indentations wherever you pressed, but by evening all her indicators had returned to normal. The hydronephrosis had disappeared, now just waiting for the urinary tract infection to improve before she could undergo extracorporeal stone removal upon discharge.
Just as Liu Zhengliang was catching his breath, the ambulance brought in another new patient.
This patient didn't even go through the emergency department, being sent directly to Neurosurgery. The head of neurosurgery was away at an out-of-town conference, and the deputy director had just submitted his resignation a few days earlier - he was going to Shenzhen to start a private medical institution and was already at the airport.
The emergency department called the deputy director, who had just checked in and was going through security. The phone rang for a long time before he answered. The junior doctor from neurosurgery said: "Director Wang, we've admitted a subdural hematoma case that's somewhat complicated. Director Li is in Beijing for the conference. Could you come back to take a look?"
The deputy director immediately responded: "No can do, I'm already on the plane about to take off. I'm turning off my phone now."
Right after the deputy director hung up, the junior doctor called Chen Junnan: "Brother Nan, wasn't that new doctor in your emergency department previously from neurosurgery? Could he come help out?" Chen Junnan naturally loved this kind of spotlight opportunity. The emergency department was the front desk - having specialized doctors ask emergency doctors for help was quite an honor. If this news reached Director Zhao of the emergency department, that would really be something.Chen Junnan called Liu Zhengliang to the neurosurgery outpatient clinic, where they saw a woman in her forties sitting in the consultation room. Upon inquiry, they learned she wasn't Kang Sheng's wife but his live-in lover. In Fushun dialect, this was called "partnering up for life." They used to be neighbors who later became involved while playing mahjong. Kang Sheng had abandoned his wife and daughter to live with this woman. Previously, his wife had pushed a cart to the market to sell smoked chicken frames to support him, while he helped at home—washing chicken frames, stewing them, and smoking them. After finishing work in the morning, he had little to do in the afternoons and spent every day playing mahjong. His wife had returned to her parents' home in tears with their daughter, and he and this woman became professional mahjong players, living off meager subsistence allowances and rent from two storefront properties. This went on for over a decade. People often find stolen food delicious, but when it's served to you daily, it loses its flavor. They used to be neighbors by day and a couple by night; now they were a couple by day and neighbors by night.
After reviewing the scans, Liu Zhengliang explained the condition to the woman, stating that Kang Sheng had a 50ml hemorrhage in his brain. The woman remained mostly silent, listening to everything Liu Zhengliang said. Finally, she signed the consent form as the family member and left.
Seeing her depart, Liu Zhengliang went to the ward to find Kang Sheng and said, "Your condition can be treated with an interventional surgery. Don’t worry too much—it’s not a big deal. Have your family prepare quickly."
After pulling an overnight shift, Liu Zhengliang needed to check in at the ward to confirm the decision. A brain hemorrhage was no minor matter, and he had waited all night in the office without any updates. He needed a clear answer on whether surgery would proceed. Finding Kang Sheng lying alone, Liu Zhengliang approached and asked, "Where’s your wife?"
Kang Sheng replied, "That woman ran off."
Liu Zhengliang pressed, "What about the surgery? After surgery, you’ll need someone to assist with meals and bathroom needs. What if no one’s here to care for you? This isn’t like surgery on a leg or arm, where you could manage on your own or hire help. This is brain surgery—how can you proceed without family?"
Kang Sheng said, "It’s fine. I have some money saved up; I’ll manage on my own."
Liu Zhengliang chuckled at this: "Then who will sign the consent form?"
Kang Sheng responded, "I’ll sign it myself."
Liu Zhengliang retorted, "Don’t joke around, old friend. Let me be clear: for this type of surgery, if there’s contactable family but no family signature, and something goes wrong, I’ll be held fully responsible."
Kang Sheng didn’t address this and instead asked about recovery time and hospitalization duration. Liu Zhengliang estimated at least half a month. By then, Kang Sheng was already feeling dizzy and confused, but he could still follow the conversation. After talking for ten minutes, Liu Zhengliang received an emergency call and returned to his duties.
That same noon, just over two hours later, Kang Sheng fell into a coma. Neurosurgery staff immediately brought a stretcher to take him for a repeat brain CT scan.
Liu Zhengliang and Chen Junnan were summoned by a call from a junior neurosurgery doctor, as both had previously worked in neurosurgery. The three reviewed Kang Sheng’s repeat CT scan together, which showed a significant increase in the area of the chronic subdural hematoma.
Pointing at the CT scan, Chen Junnan said, "Look, the midline has shifted. Surgery is definitely necessary now. Hurry and get the family to sign off so we can prepare."The young doctor looked bewildered and replied, "The problem is the patient's family ran off and won't answer their phone."
Chen Junnan: "What? Ran off? What about other family members?"
The young doctor answered, "There aren't any other family members. Otherwise, why would we be carrying the stretcher ourselves to get his head CT rechecked? We can't reach anyone."
Liu Zhengliang said he would call the woman who brought him in, then immediately called Kang Sheng's woman.
The woman on the phone said, "Don't involve me in this. Can I just sign something randomly? We're not legally married - we're just living together."
Liu Zhengliang tried to persuade her: "Forget about legal or not, out of basic human decency you should help him."
The woman immediately retorted, "Hah, human decency? At best you could call me his lover, at worst just his mahjong partner. Besides, I don't have any money."
Hearing this, Chen Junnan realized they needed to appeal to her self-interest. He grabbed the phone and said, "If you take care of him properly and something really happens to him, we can testify that you were the one who arranged his funeral procession. Then legally you'd have creditor rights regardless of whether you're legally married. You could claim a large portion of his estate. If you don't sign now and just leave him here while he's unconscious, we can't treat him properly. What kind of situation is this? If he really passes away, you won't get anything either."
The woman replied over the phone, "I'm not after anything else. The title to one commercial property was already transferred to my name long ago. I don't want any other inheritance - I've gotten what I deserved. I can't be bothered to fight his family in court later - how much money could I possibly get? Just contact his daughter - he has his daughter's phone number. Let his own daughter come sign, that's proper and legitimate. Don't look for me, it's useless anyway."
After speaking, the clattering sound of mahjong tiles being shuffled came through the phone line. This pair of mahjong lovebirds had apparently flown their separate ways.
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