I Am Diagnosed as a Medical Titan

Chapter 57: Chapter 57: Teacher Jiang’s Lecture

The next morning.

Jiang He rolled out of bed.

On his way to wash up, he heard Chen Hao snickering.

”What’s so funny?” Jiang He asked casually.

Chen Hao grinned. ”Old Jiang, Teacher Shen’s roommate, Sister Juan, she seems like my type. Hehehe.”

Jiang He smiled when he heard this.

Of course Xu Juan was Chen Hao’s type.

In his past life, Chen Hao and Xu Juan had met at Jiang He and Shen Yu’s wedding.

Chen Hao was the best man, and Xu Juan, as Shen Yu’s best friend, was the maid of honor.

They hit it off the moment they met. After just a few words, they were the type to fall head over heels in love.

Later, when Shen Yu was diagnosed with pancreatic cancer, Chen Hao didn’t hesitate. He immediately took out all the money he had saved for a new house and lent it to him.

And as his fiancée, Xu Juan naturally had no objections. She even asked her father to arrange a bed at Peking Union Medical College Hospital.

Jiang He had always kept this kindness in his heart.

His actions now had simply allowed the two of them to meet a few years earlier, saving them from several detours. It was a good thing.

After getting ready, he went to his pathophysiology class.

Today’s lecture was an extension on shock and microcirculatory hypoxia.

Halfway through the lecture, Old Xie suddenly frowned, seeming unwell.

After a moment’s thought, he said, ”Jiang He, this next part—the compensatory and decompensatory mechanisms of reduced cardiac return due to microcirculatory congestion. Do you understand it?”

Ever since Jiang He had scored a perfect first place in the preliminary round of the Clinical Pathology Reasoning Competition, coupled with the solid theoretical foundation he’d shown in recent classes, Old Xie now had complete trust in Jiang He’s abilities.

Jiang He said, ”I do.”

”Alright. Come up and take over for a bit. I need to use the restroom.”

”Okay.”

Jiang He walked up to the lectern and seamlessly continued the lecture.

He casually drew a simple diagram of a vascular branch and said:

”Old Xie just covered the ischemic hypoxia stage. As hypoxia worsens, lactic acid accumulates, causing local acidosis. This reduces the sensitivity of arterioles and precapillary sphincters to catecholamines—meaning the ’in-gate’ opens. However, the venules are more tolerant to acidosis, so their ’out-gate’ remains closed. This is the microcirculatory congestion stage, also known as the ’all entry, no exit’ phase.”

Jiang He spoke at a measured pace, his logic exceptionally clear.

In the middle rows of the lecture hall.

A boy with a buzz cut nudged his deskmate with his elbow. ”What the hell? How come it feels like Old Jiang is even better at this than Old Xie?”

His deskmate ignored him.

The boy with the buzz cut turned his head in confusion, only to find his deskmate’s head down, furiously taking notes as if he’d just had a revelation.

”What are you doing?” the buzz-cut boy asked.

”Cut the crap,” his deskmate replied without looking up.

The buzz-cut boy panicked internally.

’This won’t do. Seeing my friend actually learn something is worse than failing a class myself.’

He quickly flipped open his notebook, grabbed his pen, and also began scribbling down notes furiously.

Five minutes later, Old Xie walked in through the back door.

But he didn’t rush to interrupt Jiang He. Instead, he pulled out an empty chair in the back row, sat down quietly, and began to listen with great interest.

On the stage, Jiang He had finished explaining the basic mechanisms. He then put down the chalk and said:

”Those are the main points of the microcirculatory mechanism. Now, if we project these theories onto clinical practice, what manifestations would we see?”

Hearing this, Old Xie prepared to stand up and take over.

It was only the beginning of their third year. The pathophysiology class only required them to master the mechanisms; clinical application was generally the scope of subsequent courses.

But he didn’t expect Jiang He to continue speaking:

”Let’s stick with the example of the shock congestion stage. Due to blood pooling in the microcirculation, cardiac return drops sharply, and blood pressure will progressively decrease.”

”So, during a clinical examination, the most direct manifestation is on the patient’s skin and mucous membranes. Because of blood stasis and hypoxia, deoxygenated hemoglobin increases. The patient will not only present with cyanosis but will also have mottling on their skin. At the same time, due to insufficient effective circulating blood volume, renal blood flow decreases. If you check the urine bag, you’ll find the patient has oliguria or even anuria.”

Old Xie, halfway out of his seat, froze in place. Then he slowly sat back down, his eyes filled with curiosity.

’This kid... he understands the clinical side too?’

And he connected it so smoothly, almost like an experienced attending physician who had slogged it out in the clinics for years.

For a student, achieving this was incredibly difficult. He must have consulted countless resources in his spare time.

’Impressive, kid.’

’As expected of my, Old Xie’s, student. Hehe.’

...

After class ended, many students ran up to ask Jiang He questions.

Jiang He’s status in the class was rising. Some called him Old Jiang, while others jokingly called him Teacher Jiang.

After a brief Q&A session, it was time to head to the semifinal competition.

The semifinal wasn’t just a written exam; it also included a clinical skills assessment.

Therefore, the venue was set at the Comprehensive Clinical Skills Training Center in the south campus.

Jiang He and Chen Hao walked along the tree-lined path toward the south campus.

Chen Hao, carrying his backpack, looked around as he walked.

The closer they got to the training center building, the slower his steps became, and his tone grew somewhat timid.

”Old Jiang, look over there.”

On the steps of the main auditorium stood a few male and female students with intern badges hanging on their chests.

They stood together in small groups, their presence clearly different from the third and fourth-year students around them.

”That’s a fifth-year senior from the ’04 clinical class, Pan Wen.”

Chen Hao recognized him and explained, ”Graduate students aren’t eligible for this competition, so the fifth-years are the final bosses. I heard Pan Wen has been interning in the emergency department at Affiliated Hospital No. 1 for over half a year. His supervising doctor even lets him perform simple debridement and suturing independently. He wasn’t as freakishly good as you in the preliminaries, but the semifinals test practical skills. It feels like it’ll be tough to beat him.”

Jiang He followed his gaze for a look.

’Pan Wen. No impression of him. Our paths never crossed in my past life.’

Chen Hao continued pointing. ”And that senior with the short hair on the right, Tang Pei, another fifth-year. She won first place in the surgery division of last year’s university-wide clinical skills competition. Her knot-tying speed is terrifyingly fast. Rumor is she also wants to join Professor Yang’s group and become a direct Ph.D. student next year.”

’Tang Pei. Her, I remember.’

’Although she was my senior, in my past life, she worked as my assistant.’

’A good person, just lacked a certain spark.’

Jiang He nodded. ”Hm, that’s good.”

Chen Hao sighed. ”What do you mean, ’that’s good’? These are seasoned veterans who could crush us with their practical skills! You got a perfect score in the preliminaries, but that was all theory. Once you’re at the operating table, your hands are going to shake.”

”Let’s go.” Jiang He didn’t reply, stepping onto the stairs.

The two of them walked into the ground floor lobby.

The class president, Zhou Yang, and the Youth League secretary, Lin Yue, were there with the whole class, ready to watch the competition.

Zhou Yang was holding forth, ”I think the focus of this semifinal will definitely be on theoretical differentiation in internal medicine. The surgical skills part will be an embellishment at most.”

Lin Yue: ”Indeed.”

A student next to them immediately said, ”Class President, you can’t be so sure. Those fifth-year seniors are all on the semifinal list, and they’ve all got real clinical experience. The practical skills portion will definitely be the main part.”

”Impossible, absolutely impossible,” Zhou Yang immediately retorted. ”This is a Pathology Reasoning Competition, not the medical licensing skills exam. How can you test reasoning with surgical procedures?”

Lin Yue: ”Indeed.”

As soon as he said it, Zhou Yang frowned and contradicted himself. ”No, wait, it’s hard to say. After all, I heard the South China Region competition relies on practical skills, so maybe they will be the main part.”

”Indeed.” Lin Yue thought Zhou Yang’s last statement made a lot of sense.

Chen Hao pulled Jiang He over to chat, and their classmates showered him with encouragement.

He listened while silently flexing his wrists.

’The competition won’t be difficult, but it’s been a while since I’ve held a scalpel. This will be a good chance to warm up and get the feel for it again.’