Chapter 147: National Physical Examination (Part 1)

Seeing the excitement on Tian Fugui's face, Zhang Wenhao could easily tell that medical issues were a chronic and stubborn problem in Wanshan Township. He made up his mind to conduct as comprehensive a physical examination as possible for all the villagers here and to spare no effort in treating every single patient.

However, since he had come here and intended to stay for at least a week or even longer, he needed a suitable place to practice medicine and a place to stay. Just as he was about to ask Tian Fugui for help with these matters, Tian Fugui remembered something and looked at Zhang Wenhao with a nervous expression, asking, "Doctor, you're not just coming here for a quick visit and leaving right away, are you?"

"Of course not," Zhang Wenhao said with a smile. "Since I've come, I naturally want to examine all the villagers. It's best if everyone is healthy, but if there are any issues, I will definitely resolve them for everyone."

"That's good, that's good!" Tian Fugui finally breathed a sigh of relief. There had been a few times in the past when doctors from the county and city came to provide free clinics, but they were always just a formality. They would come, have everyone line up to take blood pressure, feel pulses, and check tongues. Examining over a thousand people would take a day or two. After a day or two, those doctors would complete their task and leave without looking back, completely failing to solve any practical problems. What he feared most was that Zhang Wenhao was also here to make a fleeting appearance, stroll around for a bit, and then pack up and leave.

Zhang Wenhao immediately said, "Village Chief, since I am here, I will be staying for a while at least. Therefore, I hope you can help me arrange a place to stay."

"Easy, easy!" Tian Fugui said immediately. "The township government has empty rooms; you can live there. The health clinic is right at the township government office, and you can treat people there."

Zhang Wenhao readily agreed.

Hearing that a top-tier student from a university had come to provide free medical treatment, the adults gathered around the village were immediately excited. Everyone hurriedly made way for Zhang Wenhao's car, and Zhang Wenhao apologized to Tian Fugui, saying, "The car is packed full of medicine and really has no room for anyone else. I must trouble you to lead the way in front."

Upon hearing that the car was packed with medicine, Tian Fugui became even more excited and nodded repeatedly. Zhang Wenhao started the engine and slowly followed behind Tian Fugui. The surrounding houses were uniformly thatched huts. Zhang Wenhao understood in his heart that it was already very difficult to even get medicine in here, so one could easily imagine the difficulty of building a brick house.

The surrounding poverty filled Zhang Wenhao's heart with deep emotion. Fortunately, the village houses were not built too tightly together, and there was a main road wide enough to accommodate this G65.

Following Tian Fugui to what he called the township government office, it turned out to be nothing more than a slightly larger courtyard. Surprisingly, the buildings here were constructed with bricks and tiles. There were five rooms in total: three main rooms and two wing rooms on the east and west. The courtyard was about one hundred square meters in size. There was no parking lot, but in the corner, there was a shed for parking a donkey cart and tethering a donkey, and a donkey was indeed standing inside.

Tian Fugui instructed a few strong laborers to push the flatbed cart out of the shed and lead the donkey away. Only then did he say to Zhang Wenhao, "Doctor, you can park your car here."

Zhang Wenhao replied, "You can just park the car anywhere in the courtyard. There's no need to take the donkey away."

"It's fine," Tian Fugui waved his hand and said, "The donkey is just idling here anyway. I'll have Zhuzi lead it to his house, and it can help him with some farm work."

Seeing that Zhuzi, the man leading the donkey, wore a happy expression, Zhang Wenhao nodded and parked the car sideways under the shed.

Tian Fugui hurriedly called an old man who was sleeping out of the main room and introduced him to Zhang Wenhao, saying, "This is the township secretary, Tian Jiefang." With that, he explained the purpose of Zhang Wenhao's visit to Tian Jiefang.

Afterwards, Tian Fugui suddenly remembered something and asked Zhang Wenhao, "Doctor, what may I call you?"

Zhang Wenhao quickly stated his name, and Tian Fugui then said, "Doctor Zhang, our township is relatively small. To put it bluntly, it's just a village called Tianjiacun. It was only designated as a township to consolidate the three villages on the mountain. The place is poor, the population is small, and conditions are limited. Please don't mind."

Zhang Wenhao smiled and said, "Rest assured, I am mentally prepared."

Only then did Tian Fugui's face light up with joy as he pointed to the west room, saying, "This is the health clinic. There's only an old local doctor, but he went deep into the mountains to gather herbs early this morning. The room opposite is empty, and I'll have someone prepare bedding for you right away. You can live here."

Zhang Wenhao nodded. As long as there was a place to stay, everything else was not a problem. He was not someone who couldn't endure hardship, and besides, the biggest purpose of his trip was to provide free clinics for the villagers in these impoverished areas while earning system points for himself.

The east room was an empty room piled with some grain. Because the air here was humid, it carried a heavy musty smell. Tian Fugui had people move all the grain out and sweep the room clean, then instructed a few young laborers to set up a simple wooden plank bed in the room. He also sent someone to his own home to ask his wife for a new set of bedding and a pillow.

To make things convenient for Zhang Wenhao, he specifically moved an old, dilapidated desk from his office into Zhang Wenhao's room. Zhang Wenhao did not refuse; he needed somewhere to put his belongings after all.

By the time all of this was done, it was already noon. Tian Fugui arranged for Zhang Wenhao to have lunch at his home and mentioned that from then on, Zhang Wenhao's meals would be provided by all the villagers of Tianjiacun. Every meal would be eaten at a different family's house, which would also help him better familiarize himself with the people and the environment here.

Zhang Wenhao did not refuse, considering that his car was mostly loaded with medicines, herbal materials, and two barrels of gasoline, and he hadn't brought much food.

When they arrived at Tian Fugui's home, his wife had already slaughtered a chicken and was making a fire to cook under the shed. Zhang Wenhao and Tian Fugui chatted idly in the courtyard. Tian Fugui had four children: three sons working outside as migrant laborers and a daughter married into the county town, which could be considered a form of escaping the mountains. Tian Fugui used to be the village chief of Tianjiacun. Later, for the convenience of administration, the county merged the three villages on the mountain into Tianjiazhuang and established Wanshan Township. After the establishment of Wanshan Township, the county did two more things than before: first, it brought electricity to Wanshan Township, and second, it brought in some bricks and tiles to build that township government office.

Through his conversation with Tian Fugui, Zhang Wenhao also learned about the human geography and living conditions of Wanshan Township. First of all, there was no industrial pollution here, so there were no local endemic diseases. The only endemic disease could be considered arthritis, because the place was nestled deep among the mountains and was extremely damp. Most people of a certain age suffered from arthritis.

There were three veteran village midwives. Basically, when a child was born in the village and it was a smooth delivery, the midwives could handle it. However, the mortality rate for difficult labors was very high because there were no surgical conditions whatsoever, and transporting a pregnant woman to the county town on a temporary basis took a better part of a day under extremely poor road conditions. Pregnant women experiencing difficult labor simply could not endure it.

When Zhang Wenhao asked why they didn't go to the county hospital to await delivery before the due date, Tian Fugui explained with a simple, direct, yet very convincing reason: no money.

Where would the money come from? Having a child at the hospital would cost at least a few thousand yuan. The villagers here basically didn't spend money on ordinary days; most of their annual harvest went toward food rations, and whatever was left over was sold to exchange for a little cash to buy daily necessities. Anyone in the village who could have a thousand yuan in savings would already be considered remarkable. The cost of childbirth was too high for ordinary people to bear.

Young people with bolder spirits basically ran off to work as migrant laborers. If a family had someone working away from home, their financial situation would be slightly better; otherwise, everyone else was uniformly destitute.

Zhang Wenhao felt a deep sense of emotion in his heart, thinking that he must do his utmost to contribute a meager share and do something for the people here. During lunch, he said to Tian Fugui, "Village Chief, could you please use the loudspeaker later to make an announcement and ask the elders and young folks of Tianjiacun to come to the township government office after they finish eating? I will give them physical examinations."

Tian Fugui nodded repeatedly and said, "Will do, will do. I'll go notify everyone as soon as I finish eating."

After the meal, Zhang Wenhao and Tian Fugui returned to the township government office. Zhang Wenhao took out some medical tools from his car, set up a table in the courtyard, and prepared to conduct physical examinations for the villagers right there—first identifying problems, discovering issues, and then resolving them one by one.

Tian Fugui shouted a few words through the loudspeaker in the local dialect. Soon, a large crowd of villagers flooded into the township government office, including men, women, old, and young, though the majority were middle-aged, elderly, and children, with relatively fewer young and strong adults.

Zhang Wenhao then said to Tian Fugui, "Village Chief, please tell everyone that we will start with the children first, then the elderly, and finally the middle-aged and young adults. Have everyone line up consciously, and the young adults can go back to busy themselves for now and come back later."

Tian Fugui nodded, raised his voice, and shouted a few sentences. Some of the young and middle-aged adults left with smiles, leaving behind only the elderly and children. Tian Fugui knew everyone here and had them line up, starting with the children.

Zhang Wenhao opened his laptop and created an Excel spreadsheet. Every time Tian Fugui called someone forward, Zhang Wenhao would ask for their name and record it.

Although the children were relatively mischievous on ordinary days, they were all very well-behaved now. One by one, they lined up in an orderly fashion and walked up to Zhang Wenhao.

Zhang Wenhao did not have too much medical equipment, and things like sphygmomanometers were basically useless for children, so he primarily relied on feeling their pulses.

Even just feeling pulses was far superior to ordinary traditional Chinese medicine practitioners. As long as it was not a nervous system disorder, pulse-taking could basically uncover it. Zhang Wenhao examined seven or eight children in a row and found that aside from some nutritional imbalances, these children were generally healthy and sound.

A few children had slightly weaker constitutions. After diagnosing them, Zhang Wenhao found that many of them had parasites in their bodies, so he handed out two tablets of albendazole to each of them.

The health conditions of nearly a hundred children were considered quite good, and no serious illnesses were found. Just as Zhang Wenhao breathed a sigh of relief, a woman holding a three- or four-year-old child in her arms ran over in a panic.

"Doctor, please take a look at my Gouchan! He's been having diarrhea for three days, and the doctor at the health clinic prescribed herbal medicine, but it hasn't improved at all after drinking it."

Zhang Wenhao basically could not understand what she was saying, so Tian Fugui acted as an interpreter. After understanding, Zhang Wenhao looked at the child in the woman's arms and was shocked to find that the child's condition was extremely poor, his spirit was extremely listless, he was severely emaciated, and his eye sockets were slightly sunken.

Zhang Wenhao hurriedly stepped forward, touched the child's hands and feet, and found that his limbs were ice-cold. Subsequently, Zhang Wenhao took the child's pulse and discovered that the child's heart rate and pulse were much weaker than those of a normal child.

"Has the child urinated in the past two days?" Zhang Wenhao asked anxiously.

"No," the woman shook her head very affirmatively and said, "He just has diarrhea, non-stop diarrhea."

Zhang Wenhao frowned tightly, felt the pulse again, and checked the skin turgor of the child, finding that the skin elasticity was extremely poor. He said, "The child should have contracted enteritis. With three days of diarrhea, he is now in a state of severe dehydration."

When Tian Fugui heard "severe dehydration," although he didn't understand the specific medical meaning, he knew the child was lacking water. Seeing the child's listless state, Tian Fugui couldn't help but curse, "You foolish woman! Why didn't you give the child water!"

Zhang Wenhao vaguely understood some of it, while the woman wore an innocent expression. Zhang Wenhao then explained, "Village Chief, the child's dehydration is a loss of body fluids, which cannot be resolved simply by drinking water."

With that, Zhang Wenhao continued, "The child's current condition is already extremely critical. If he goes into shock, it will be troublesome. Let's pause the physical examinations for a moment; I will mix a batch of 3:2:1 isotonic intravenous fluid for this child."

Having said this, disregarding Tian Fugui's puzzled look, Zhang Wenhao turned around and retrieved glucose water, normal saline, and sodium bicarbonate solution from his car. Strictly mixing them according to the correct proportions, he took out a syringe, walked over to the child, asked the woman to place the child on the office desk, and then located the child's blood vessel, inserting the needle with extreme precision.

The child had not yet reached the point of shock, so volume expansion and acid correction were not urgently needed, but Zhang Wenhao slightly accelerated the infusion speed to quickly alleviate the emergency situation of the child's massive loss of body fluids.

The greatest danger of pediatric diarrhea caused by enteritis is dehydration. As long as the dehydration problem is stabilized and appropriate anti-inflammatory and anti-diarrheal medications are prescribed, the condition can be brought under control. With continued medication, recovery could be achieved in a few days.

After starting the IV drip for the child, Zhang Wenhao said to Tian Fugui, "Have the child lie down on my bed, cover him with more dry blankets, and maintain his body temperature."

Tian Fugui said, "The west room is the health clinic; there are hospital beds and IV poles there. Let's go there."

Immediately, Tian Fugui picked up the child. Zhang Wenhao held the infusion bottle high and carried the child to the dilapidated hospital bed. The makeshift IV pole beside the bed was even DIY-ed out of bamboo.

Knowing in his heart that the child's condition would soon be alleviated—and once alleviated, medication could be used to cure the root cause—Zhang Wenhao finally let out a sigh of relief. However, he felt a deep sense of emotion: the child was suffering from acute enteritis, but the township's medical level could only prescribe him herbal decoctions. For a disease like acute enteritis that erupted in a short period and rapidly reached its peak, traditional Chinese herbal medicine acted far too slowly and simply could not keep up. Moreover, since the child was already suffering severely from diarrhea, herbal medicine entering the stomach would be excreted by the child before it even had a chance to release its medicinal properties. Treating this kind of illness with oral medication had limited effects; intravenous injection was the best and fastest pathway.

Without antibiotics or the conditions to prepare isotonic rehydration fluids, I am afraid this child's life would not last much longer. The conditions here were too poor; the parents were simply incapable of sending the child to the county for treatment and instead pinned their hopes on herbal medicines taking effect. If they waited until the child went into shock before realizing the seriousness of the problem, even if they could manage to send the child alive to the county hospital, they would only be rushed straight into the emergency room.

Zhang Wenhao could not help but exclaim: the phrase "lack of medical care and medicine in impoverished areas" is something that must be borne with human lives!

After settling the child in, Zhang Wenhao came back out to continue conducting physical examinations for the remaining villagers.

The health conditions of the elderly were extremely worrying. Almost every elderly person suffered from malnutrition, and to them, this could only be considered a minor issue. Patients with severe rheumatoid arthritis even needed others to support them just to walk. They couldn't even stand on their own and had been bedridden at home for a long time—not truly paralyzed, but worse than paralyzed. This problem was also very severe and extremely widespread.

Regarding malnutrition, Zhang Wenhao had no way to intervene directly; this situation required not only a balanced diet and nutritional intake for the elderly but also proper exercise and a healthy daily routine. Zhang Wenhao could only advise these arthritis patients one by one: try not to give up moving just because of the pain, take a few appropriate steps every day, and even if leaning on a crutch, move the body appropriately. They must never remain bedridden all day long, as that would only worsen their condition.

There were simply too many arthritis patients for Zhang Wenhao to treat one by one in a short time. He could only write down their names first, then take the time to prepare a batch of dampness-dispelling herbal decoction for them to soak their joints in, followed by acupuncture treatments. This damp-dispelling decoction was a traditional Chinese medicine formula contained in the top-tier medical skill package. This formula was improved in later generations through scientific analysis of ancient methods combined with high-tech research, and its effects were exceptionally good. If he could gather all the ingredients for the damp-dispelling decoction, he would be confident in curing all the rheumatoid arthritis patients here.

In addition to this, an elderly person had impaired heart function, which Zhang Wenhao recorded down to perform a systematic diagnosis and treatment for her on another day; four people had hypertension, though fortunately Zhang Wenhao was equipped with antihypertensive drugs, and acupuncture could also play an auxiliary role.

An elderly woman had extremely weak lung function. Even sitting motionless, she panted heavily when speaking, as if she had just climbed six or seven flights of stairs, which alerted Zhang Wenhao. He carefully listened to the old woman's lungs with a stethoscope and asked her about her general condition.

The old woman said that she had problems with her lungs for more than three months, and her condition was getting worse by the day. Previously, she only experienced shortness of breath, but now not only was her breathlessness extremely severe, she also produced a lot of phlegm, felt weak all over, and found walking extremely difficult. Coming over from home today, even for such a short distance, she had to rely on her son to push her in a handcart.

Zhang Wenhao's heart tightened. Through his diagnosis, he found that the old woman's lung function was already extremely weak, which in turn severely affected her entire body. At present, she was reduced to skin and bones, and her bodily organs were showing signs of failure.

These symptoms led Zhang Wenhao to basically conclude that the old woman was suffering from lung cancer, and it was likely in the late stages. Her cancer cells had probably metastasized long ago, and tumors should have already grown inside her trachea. Her life could end at any moment, and the most likely fatal factor was respiratory failure. In other words, if she failed to catch her next breath, she might collapse forever.