The Apothecary Diaries - Volume 15 - Chapter 11

Chapter 11: The Special Unit

It came half expectedly, half out of the blue.

The physicians were summoned to a conference room. Maomao was asked to attend in the nominal position of secretary, but when she saw who was gathered, she had a pretty good idea what they were there to talk about.

Dr. Liu, Luomen, and Tall and Short Seniors were there. Mid- Height Peer was missing. Instead she saw Tianyu, goggling at the room around him, and a collection of other accomplished and capable doctors.

Perhaps most interesting of all, Dr. Tairan was there as well. Maomao had given him Suirei's notes just the other day-telling him, as she had promised, that they were left behind after Suirei's death. One thing was different from before: Dr. Tairan walked tall, much taller than Maomao might have expected from someone derided as a coward.

Maybe he knew I was BS-ing about the notes being "personal effects."

Maomao also spotted a woman she'd seen during the selection exam. In fact, everyone there had passed the same examination. 

This has to do with the Emperor, no question.

Normally, Maomao would have expected to be excluded just like Mid-Height Peer. The whole calling-her-in-as-a-secretary thing must have been Jinshi's doing, or possibly at Luomen's intercession. It did annoy her, though, that Tianyu was there on his own merits.

In spite of being a trash human being!

Even Maomao had to admit that surgical skill was one area in which he couldn't be faulted.

Maomao seated herself beside Luomen and started taking notes on a pad. Luomen was the center of discussions about the medicines involved, while Dr. Liu was leading talk about the surgery itself. There was another group, too, one that was researching medicines for after the procedure.

Before surgery, during surgery, after surgery.

Those, Maomao realized, were the groups into which they had been divided.

Some weatherbeaten old papers were carefully arranged on the table in front of Dr. Liu-the reconstructed remnants of Kada's Book. The pages showed illustrations of an autopsy. Judging by the fact that only physicians were present and the door was locked, the intention must be for everyone to see the pages.

Did Jinshi give those to him?

Any ordinary person would look askance at the book, but to the likes of Maomao and Tianyu the content was absolutely fascinating. Of particular interest to Maomao was that the autopsy illustration included copious notes about diseases of the internal organs; she hoped to have a chance to study it closely later.

I didn't get a good look before, she thought. There simply hadn't been time.

"I want to hear how each of our subjects is progressing," Dr. Liu said.

Tall Senior stood up. "Currently, we've confirmed that the medicine is effective. However ... "

There was an obvious difference between the group that had received the real medicine and the one that had gotten the placebo. The real medicine worked. However, there were variations by individual, and even within the group that received the drug, some people got better and some didn't. The ones who were cured appeared to be those who'd had mild symptoms to begin with. Still, the condition seemed to worsen more slowly than in the placebo group.

Luomen then elaborated a bit on what Tall Senior had reported. Dr. Liu looked as if it was all about as he had expected. Maomao rapidly took notes. She'd known all this already, so writing it down was easy.

After that, it was the surgical team's turn to report. First, Tairan and an upper physician skilled in the use of needles talked about anesthesia. In addition to the use of herbal medicines, they discussed the possibilities of alcohol, needles, pressure, and cold to reduce pain. Of course, the more a method eliminated pain, the more dangerous it was. They mentioned a number of dangerous names like thornapple, wolfsbane, mandrake, poppy, and cannabis.

When you're cutting open someone's stomach, pain is probably inevitable, Maomao thought. The question was how much the patient could take. There were plenty of legends and tales of great heroes having surgery done on them without minding the pain at all-but if they could blunt the discomfort somehow, it would decrease the chance of the patient going berserk during the operation.

Should anesthetic herbs be considered medicine, or poison? It was a difficult distinction to draw.

Having talked about the possibilities, Tairan then suggested an anesthetic that was a compound of several different drugs. He would not use alcohol, but a concoction including sleeping medications to take the edge off the pain.

If we're really lucky, we'll be able to perform the operation before he wakes up.

Maomao continued taking down notes, trying her best to be accurate. There was one other person taking notes, a physician, so if she made any errors, they could compare her notes with his.

She was surprised to realize that research on the surgical procedure had come so far.
Maybe Kada's Book helped them.

Once the procedure was over, she fully intended to have a better look at it.

"Concerning the illness itself, while this is not unqualified, we believe we've found a way to solve the problem at its source."

Maomao's eyes widened and she looked on with undisguised interest. This subject was so important that Dr. Liu himself was doing the presentation.

"If it should happen that the problem is not in the cecum but in the appendix, we'll prevent any further recurrences by removing it. The autopsy illustrations have shown us that it often is the appendix that's the actual problem."

"Maomao," Luomen said, nudging her. She'd been so busy watching Dr. Liu that she'd forgotten to take any notes, and she hurried to catch up.

The appendix: If she remembered correctly, that was the little thing hanging there like a worm that she'd seen when they'd done their dissections.

"Are we sure it's all right to remove the appendix?" asked one physician. Maomao was grateful to him: It was exactly what she wanted to ask.

"It's reputed to be a relatively safe organ to remove," Dr. Liu replied. "At the very least, we know the damage would be far worse if we were to simply let filth continue to collect in the appendix until it burst."

That would send the stuff all over the inside of the abdomen, likely causing other illnesses and finally death.

Kada's Book, sitting before Dr. Liu, contained detailed drawings of the appendix. The fact that the book was sitting there suggested just how much help it had been.

"Has this surgery been tested?" someone asked.

"Yes, it has. We've been watching the patients' progress, and it appears to have an eighty percent success rate."

"What happened to the other twenty percent?"

That was the more important subject versus the cases that succeeded.

"In ten percent, the appendix had already burst, causing peritonitis. We removed the appendix and tried to clean out as much of the filth as we could, but the condition ultimately claimed their lives. In the remaining ten percent, toxins entered via the surgical incision and caused infection, and the patient died without ever fully recovering."

Twenty percent. Were those odds high, or low?

It's not a very comforting number, that's for sure. Yet at the same time, it was a far greater success rate than had been possible with the methods available before this.

"What do we do if the appendix isn't the site of the problem?" asked a physician.

"We'll just have to cross that bridge if and when we come to it," Dr. Liu replied. It was as good as telling them that they had no time. Maomao continued to make her notes, trying to keep them as objective as possible.

Finally, there was an explanation of how treatment would be handled after the surgery. It mostly concerned antiseptic drugs and how to maintain hygiene so that nothing would become infected.

I guess our group doesn't have much to offer His Majesty, Maomao thought. If they were working on the assumption that they were going to operate, then he was probably past the point of being cured with herbal medicine.

"Pardon me, but may I ask something? Just to be certain?" said the physician who had talked about anesthetics, raising his hand.

"Go ahead."

"Who are we going to use the fruits of all this research on?"

It was a real question-but he was "just being certain." Most likely, everyone in the room already knew the answer.

"It's precisely the person that you're all thinking of," Dr. Liu said. He didn't elaborate. Maomao didn't know if that was the right choice, but the very fact that he chose not to showed just how uncertain the endeavor was on which Dr. Liu was embarking.

They were going to do surgery on the Emperor. Meaning they were going to give him drugs that could poison him if they made the slightest error, then cut open his abdomen with a knife, possibly cut out one of his internal organs-and even if the surgery succeeded, he would need meticulous attention after the procedure.

If everyone here were to be considered involved, it could gut the entire medical department.

Therefore, they had to keep specific knowledge of the surgery to the minimum number of people.

Dr. Liu, my dad, maybe a few others

To fail would be to effectively sign their own death warrants. It was even possible that punishment could extend as far as the ninth degree of their family.

Which means I'd be killed too.

The freak strategist and Lahan would be caught up in it; there nothing they could do about that, but she wondered if it might be possible to at least spare Lahan's Brother somehow.

Of course, Maomao couldn't picture Luomen, whom she respected so deeply, making such a mistake.

"I'm going to read off a list of names," Dr. Liu said. "I want those people to stay here."
 
He started reading. Every person whose name he called looked grim but resolved. Well, except one-Tianyu looked cool as a cucumber.

He's got real skills ... if nothing else, Maomao thought with a click of her tongue.

Dr. Liu had one more name to read. "Maomao."

Hrk ?!

Maomao jumped a little when she heard her name. She saw Short Senior leave the room, casting a worried glance in her direction. She knew how he felt: she sure hadn't expected her name to be among those called. The drugs she had been making wouldn't be much use after the surgery. She got up, staring openly around the room, and worked her way toward Dr. Liu. Tall Senior was still there too; his name must have been in there somewhere.

"You look like a woman who doesn't know why she was on that list," said Dr. Liu.

"Yes, sir," Maomao replied.

"It's simple. You're Luomen's blood relative. If they're going to wipe out whole families, then better to bring you into the fold than someone else who otherwise wouldn't be involved. Fewer victims that way."

"I see, sir."

It certainly was a logical enough reason.

"As a bonus, if anything happens, you'll be an easy way to get Grand Commandant Kan involved. Luomen would be a good start for that, but a little insurance never hurt anyone."

"I see, sir," Maomao said, narrowing her eyes. They were probably hoping that, if the death penalty came for them, the freak strategist would kick and scream and go on a rampage and get the sentence vacated.

Dr. Liu always seemed to be one step ahead of her.

Maomao spent the next several days being told what the surgery would entail-but in keeping with the principle of a time and a place for everyone, her main job was going to be choosing and compounding the drugs they would use.

At Luomen's instruction, she bought the finest herbs and put them to use with the utmost care. Practically speaking, she'd been inducted into the post-surgical care team. Tall Senior was part of the same group, but was also receiving instruction for how to assist during the surgery; they must have decided he would be useful in both circumstances.

Short Senior, meanwhile, was continuing the experiments with the drugs. Patients whose condition worsened would be given an anesthetic, receive surgery, and then their progress tracked.

The anesthetic was the biggest problem. The most effective anesthetics were also the most toxic. Hence, they decided to try to use something that might be less effective but was also not so deadly.

A patient who was still young and unused to pain would never be able to endure being cut open while still conscious. Dr. Liu seemed to have decided, however, that the Emperor would oblige them. It just went to show how chronic the ruler's pain had been, and how much force of will it must have taken to make it appear as though the condition had no impact on his work.

Everything seemed to be proceeding smoothly ... until a high official appeared and exclaimed, "Surgery ?! Don't be absurd!"