This Doctor Is Too Wealthy

He had no energy left to pass judgment on this headstrong family member.

After taking a deep breath, Director Su opened his eyes and turned to Du Heng. ”Director Du, in this situation, does traditional Chinese medicine have a way to control the woman in childbirth’s blood sugar?”

A slight twitch touched the corner of Du Heng’s eye.

He didn’t answer Director Su’s question, instead saying quietly, ”The woman in childbirth is too obese. Using external cephalic version now presents too great a difficulty.”

After a brief pause, Du Heng continued, ”Her amniotic fluid has broken, and the cervix is fully dilated. I believe adjusting the fetus’s position using internal cephalic version is feasible. Have you not considered this method?”

Internal cephalic version?

Director Su gave a bitter smile. ”How should I put this? Since the advent of the cesarean section, this combined version has fallen out of common practice. There aren’t many who know how to perform it anymore. I learned a bit about external cephalic version, but that’s limited to having learned of it and knowing it exists.”

Director Su sighed heavily. ”Moreover, the risk of internal cephalic version is also very high. A mistake could lead to uterine rupture, internal hemorrhage, and other complications. The risk is too great. As for the woman in childbirth’s current condition, you’ve seen it too, Director Du. Her blood sugar remains high. If even the slightest accident occurs, it will be truly... SIGH. That’s why I called you, Director Du, to ask if traditional Chinese medicine offers any way to manage this situation.”

Du Heng shook his head slightly and said slowly, ”High sugar implies heat, and lowering sugar involves cold. This is the general rule for diabetes, so to lower blood sugar, bitter and cold medications are needed. Given the current condition of the woman in childbirth, we must rapidly lower her blood sugar level, which will require strong medication. But bitter and cold medications place a burden on the body, and they also harm the fetus in the woman in childbirth’s womb. This is the same reason you hesitate to use large doses of medication.”

Director Su shook his head, a hint of disappointment in his eyes. He sighed again, then turned to the female doctor. ”Issue a Critical Illness Notification and speak with the family. Also...”

A sudden pause was followed by silence. After about three to five seconds, Director Su continued, ”Continue the medication. For as long as the fetus can still hold on, keep administering it, and try to bring that blood sugar down.”

What is the role of a Department Director? Beyond identifying and rectifying shortcomings, much of the time, they are the ones making crucial decisions for the doctors and nurses. The available treatments and methods are generally known to all physicians; what a Department Director possesses, that other doctors may not, isn’t just a slightly larger reserve of knowledge. More importantly, it’s experience and the ability to manage dangerous and critical situations. And, of course, it’s about shouldering responsibility. That was precisely what Director Su was doing now.

The female doctor let out a sigh of relief and was about to leave the delivery room when Du Heng stopped her. ”Wait.”

What? Everyone looked at Du Heng with confusion, not understanding what he intended to do.

”What’s wrong, Director Du?” Director Su asked, turning his head in confusion.

But at this moment, Du Heng hesitated again.

It was strange. When he had entered Wu Shengnan’s delivery room earlier, aside from heightened emotions, he hadn’t felt anything particularly unusual. But upon entering this delivery room, that long-absent sensation returned—a burning pain at the corners of his mouth.

DAMN! A National Treasure of a phrase welled up in Du Heng’s mind.

He hadn’t experienced this for over a year, so much so that he had almost forgotten he even had such an irritating affliction. But the sensation now reminded him, all too clearly, that he was still the same old him. Entering a delivery room or a confinement room would still trigger his ’condition.’

Thinking about the position, posture, and steps involved in an internal cephalic version, Du Heng began to have second thoughts. However, the woman in childbirth’s constant groaning made him feel like he was sitting on pins and needles.

Seeing that Du Heng didn’t speak, Director Su had to ask again, ”Director Du?”

PHEW. Du Heng took a deep breath, looking earnestly at Director Su. ”Director Su, I know how to perform an internal cephalic version. Shall I give it a try?”

”You can?”

”Internal cephalic version?”

Hearing Du Heng’s words, Director Su was momentarily stunned.

How could someone from the Traditional Chinese Medicine Internal Medicine Department know something that even he, the Director of the Obstetrics and Gynecology Department, didn’t? True, Traditional Chinese Medicine Internal Medicine did cover some aspects of gynecology and obstetrics, but internal cephalic version was such a specialized technique. It wasn’t something a TCM internal medicine doctor should know, was it?

Du Heng saw Director Su’s confusion, as well as the doubts from the surrounding medical staff. He sighed and explained, ”Director Su, before I came to this hospital, I was the Dean of Jinzhou Maternity and Child Health Care Hospital. Knowing a few obstetric techniques shouldn’t be that surprising, should it?”

Hearing Du Heng’s explanation, Director Su gradually regained his composure, but then he shook his head. ”Director Du, that’s not what I meant.”

Saying this, he glanced back at the woman in childbirth. ”You’ve seen her condition, and you understand the situation. This is no joking matter. You should be aware of the risks of internal cephalic version, right?”

Du Heng made up his mind. It would be uncomfortable, sure, but it wasn’t anything he hadn’t experienced before. A few blisters at the corners of his mouth, a burning and tight sensation for a few days—that was all. ”I know.”

Hearing Du Heng’s clear answer, Director Su began to hesitate. ”Then... then... Director Du, have you performed similar... pro... procedures before?”

Director Su, for a moment, couldn’t find the right word to describe ”internal cephalic version,” so he settled for ”procedure.”

Du Heng shook his head. ”I haven’t performed an internal cephalic version before, but I’ve used external cephalic version for a difficult labor case.”

If Du Heng hadn’t said anything, it might have been better. Director Su might have conjured up images of Du Heng being trustworthy. But hearing him admit he’d only performed it once, and an external cephalic version at that, Director Su no longer hesitated.

Could he let Du Heng do this? Who would dare? If he allowed Du Heng to do it, wouldn’t that be tantamount to letting him use the patient for practice?

Director Su opened his mouth, about to refuse.

However, the groans of the woman in childbirth behind him assailed not only Du Heng’s ears but also his own nerves.

It was clear that if an internal cephalic version wasn’t performed now to allow the fetus to be delivered naturally in the correct position, the only alternative was a high-risk cesarean section.

For diabetic patients, if blood sugar is well-controlled, the main surgical risk is slightly slower wound healing. However, with her blood sugar currently so high, the risk of postoperative infection would skyrocket, and wound healing time would be significantly prolonged. And that wasn’t even the biggest problem. The greatest danger lay in the surgery itself. Performing surgery during a state of hyperglycemia can heighten the body’s stress response, making postoperative blood sugar even harder to control. It also exacerbates inflammatory reactions, increasing the risk of acute diabetic complications such as ketoacidosis, starvation ketosis, hyperosmolar coma, and others—any of which could be fatal.

What should he do?

Director Su opened his mouth but couldn’t utter a word of rejection.

Of course, he could steel his heart and proceed with conventional treatment: issue the Critical Illness Notification and continue efforts to lower her blood sugar. If the fetus in her womb was resilient enough to wait, and the woman’s blood sugar could be brought down, then the woman in childbirth would endure some suffering, but the fetus might also survive. If they couldn’t wait, or if the woman in childbirth’s blood sugar didn’t come down, then, unfortunately, it would mean the fetus’s destiny with this family was insufficient. In that scenario, the woman in childbirth would suffer, but her life would likely not be in danger.

But could the fetus wait?

Director Su gently closed his mouth again.

With the woman in childbirth’s water broken and cervix fully dilated, every minute of delay meant another minute of suffocation risk for the fetus. If the oxygen deprivation lasted too long, even if the fetus didn’t die, the damage to the brain could be enormous. The image of a pediatric patient with ”cerebral hypoplasia” caused by oxygen deprivation—in other words, a child with ”cerebral palsy”—began to surface in Director Su’s mind.

Director Su fell silent. The medical staff attending to the woman in childbirth also fell silent. They all knew what was happening to her. But they were powerless now; they could only wait for their Director to make the final decision.

And that decision carried immense risks.

If Du Heng succeeded, it would be a joyous outcome for all. Du Heng would make a name for himself in the Obstetrics Department, and his prestige within the hospital would rise to another level.

But if he failed, the one who made the decision would be the one to bear the responsibility.