Plague Doctor

Chapter 310: Pre-op Consultation (3in1)

Gu Jun put on the protective suit before hurrying back to the sickroom. Now the contagiousness of Xie Yiman’s illness was brought back into question. After all this was not a normal dermatological illness but it could be the prodromal stage of a transmutative disease. When he returned, Xie Yiman was more sentient than when he left her as she called out his name once she saw him, “Captain Gu, Captain Gu!” Gu Jun noted for himself the new facial symptoms that Uncle Dan described on the way back. The infected area on the patient’s face expanded. The irregular erythema previously consigned themselves to the patient’s cheeks but now it was spreading. According to this rate, the rash would be all over the patient’s face by tomorrow morning. Furthermore, there appeared to be scaly flakes of skin forming above the erythema. The white epidermal layer cracked to resemble little red flecks of scales.

Gu Jun saw an illusion of this illness spreading to every inch of the patient’s skin and the edematous would exacerbate until the skin completely fell off. It would be a case of dermatitis exfoliativa like the young girl Gu Jun saw in Xie Yiman’s mental world. However, after the human skin was removed, a new dermal layer would replace it, a scale-like keratinized skin with different pigmentation.

“So itchy, so many worms...” Xie Yiman’s word reflected the change in her mental state, “They have crawled to other places. Please help me...” Gu Jun conducted some inspection and he turned away with a frown.

“The patient probably has entered the second stage.” He informed the command central darkly, “The previous stage is probably the prodromal stage, the chance of this being the Mutated Scale Disease has greatly increased.” Even though currently Xie Yiman was the only one with this new symptom, this proved some dire facts. This was more than a mental disorder, it was also a neurological abnormality. The doctors were faced with problems in the patient’s neurological system that current medicine did not understand that much.

Mutated Scale Disease, if this was what it is, was not good news. Gu Jun reminded the command central to take a sample of Xie Yiman’s scale-like skin flakes to make DNA comparison with the scale he brought back from the Dreamlands and the skin of the Deep Ones. He had a feeling the Deep Ones would be the breakthrough but the damn system still had not provided him with the abyssal mission of dissecting them.

Once Xie Yiman’s new symptom appeared, the experts at headquarters and He Bei City’s People Hospital had to discuss new treatment methods.

“Ah Jun, we have to consider the possibility of surgery.” Zhang Donghai told Gu Jun, “The condition of the patient is worsening too fast, we can’t waste anymore time.” Now they were faced with mainly two solutions. One was to sever the patient’s mental connection with the pathological source, which was supernatural-based; and the other was to slice off all the mutated skin and transplant them with new skin, which was based in modern medical science.

“We can start with radiofrequency rhizotomy on her trigeminus and nervus facialis to observe its effect.” Zhang Haidong suggested. When they dealt with Nightmare Illness, they attempted lobotomy, a surgery meant to destroy the patient’s central stem nerves, to disrupt the patient’s connection to the Nightmare House. It helped to greatly reduce the speed of mental degradation. Now this method could be replicated by destroying the facial nerves on the patients of Mutated Scale Disease.

The second method could prove effective too. Once the diseased tissue was removed, the illness would be manually extradited from the patient’s body, this proved successful when treating patients of Malformed Banyan Tree Disease. However, if this was a neurological illness, excision of the old skin would not help anything. Therefore, when both solutions proved equally unreliable, the team of doctors leaned towards the former. The main reason was radiofrequency rhizotomy (also known as radiofrequency lesioning, short formed as RFL from now on) had a lower risk.

“Hmm...” Gu Jun frowned deeper. Even for normal people, the negative consequences from RFL could be unbearable. Trigeminus was a complex nervi cerebralses, it has three nerval functions: pain, touch and movement. RFL could control the zone of the damage. For example, RFL is mainly used to treat prosopalgic patients.

The treatment theory is very simple, the electrode will be inputted into affected nerve clusters to destroy the nerves ending that cause pain while leaving the nerves endings responsible for touch and motor function untouched. When your brain cannot receive the pain stimulus anymore, you would not feel the pain. But the surgical effect might not always be idealistic. Some patients lost all functions after the surgery. They suffered from facial numbness, in severe cases, the surgery might even influence the motor skills of the tongue, eyes and nose, causing speaking, and even breathing difficulty.

For now, the medical team suggested a surgery that would only maintain the motor skills or at least they would try to. However, the trigeminus was not the only nervi cerebalses the surgeons suggested they operate on. The second RFL was meant for nervus facialis—this was a complex nervi cerebralses that mostly monitored the facial motor skills that manifested facial expressions. Its destruction would cause facioplegia. Basic expressions like arching the brows, puffing the cheeks and pouting would be impossible. Xie Yiman was an actor, a young star on the rise, ruining these two nerves would equal to ending her career. Was that something she could accept in her current mental state?

“Ah Jun, do you think we should explain the complication of the surgery to the patient?” Elder Tong at the command central asked. Gu Jun was silent. This was a conundrum. If he told Xie Yiman, the girl might mentally collapse. But if he did not, it would give the dark forces the chance to fester. When she found out her life had been ruined without her permission, the consequence would be horrible...

“Let me think about it...” Gu Jun could not make the decision. “I feel like this kind of decision should be made by the patient herself...”

“Then you should help her consider it.” Zhang Donghai showed compassion and encouragement, “We doctors are tasted with jobs like that too.” How to deal with the patient’s psychology, how to explain the necessity of the surgery and how to ease the patient’s tension pre-surgery was one of the doctor’s main responsibilities.

This task was handed over to Gu Jun because Xie Yiman was his patient. For the other 155 patients, despite their celebrity status, the government was not going to show them preference. The command central had already selected 45 individuals for RFL. The 45 individuals were selected from different backgrounds, gender and stages of illness, to complete the sample variation. The 45 individuals were separated into 3 groups, 15 patients per group. The first group would have their trigeminus removed, the second group their nervi facialis and the third group both. Another control group would be set up for comparison.

At the same time, other patients were sent into other preparatory experimental groups. One group was planned for sensory rhizotomy of the trigeminal nerve, this was a brain surgery. If RFL did not work, they had to go for a more invasive surgery, of course it came with bigger risks and more possible side effects. Another group was planned for dermatomy and skin transplant. They had to cover all bases.

However, Xie Yiman’s treatment would be left in Gu Jun’s hands. As the only patient with the second stage of illness, her condition was very unique. At the prodromal stage, RFL or dermatomy might work but perhaps not at her stage. Not all patients had the choice of accepting or denying surgery, but Gu Jun wanted to give Xie Yiman the right. However, he also understood that this illness was more than just one Xie Yiman, it had consequences that could be felt all over the world. Before returning to the sickroom, Gu Jun found Wu Siyu to chat, he unloaded upon her his sense of loss.

“So anything is possible and no one knows what will happen.” Wu Siyu concluded, “I finally understand why I chose not to be a doctor.” She patted his shoulders, “Dirty-minded Jun, if I was you, I would give her hope. I would show her the picture of you as the Nightmare Man and then share the story of the Dreamlands and the golden aloe with her. Show her the hope that her facial palsy could be treated. Tell her about the Great Atal and how powerful he is, he might have ways to treat her.”

“That will indeed make her feel better...” Gu Jun concurred. “With hope, there’s a reason to live and technically I won’t be lying.”

“Hmm.” Wu Siyu nodded. “One can live without a face but not without a heart.”

“Okay, I’ll do it your way.” Gu Jun decided, “After all, who am I to question the Goddess of Hope?”

When the two entered the quarantine room, Xie Yiman could already move on her own but accompanying that sentience was a vengeful return of the itchiness and a deep panic. Earlier, Xie Yiman pleaded desperately for a mirror. After being given the permission by Gu Jun, the nurse handed her one and now the young star was sitting in her bed soulless and numb.

“When I was in the coma, I think I saw a person...” She mumbled, “The skin on her face was falling, will that happen to me too?” Gu Jun comforted her as best as he could and asked her some more questions. Xie Yiman did not have any female friends who was a livestreamer and she did not interact with the young girl in her coma. She only stared at the other girl from a distance. The girl eventually ran away. Just as Xie Yiwan was about to surrender to the darkness, she felt someone pull at her. And the itchiness eased. When Gu Jun asked more about the force of the pull, Xie Yiman described it as a faded sweet scent. So it was indeed Deng Ximei who saved her.

“Yiman, I want you to take a look at these pictures.” Gu Jun handed her Wu Siyu’s phone, it contained the pictures of him when he was the nightmare man.

“Who is this?” Xie Yiman was befuddled. This person looked to have more serious facial scarring than she did.

“This was me.” Gu Jun answered. He reported his action to the superior. They approved of it but the golden aloe had to be kept a secret. They were afraid that its revelation might put the Zoogs in danger. Gu Jun agreed so he only told Xie Yiman about the Dreamlands and its magical medicine as well as the power Great Atal. The cultists could have assaulted Ulthar but they did not, Gu Jun believed it had plenty to do with Atal and the cats. There had to be a reason why Ulthar could be a sanctuary at a place as dangerous as the Dreamlands.

“If my face can be cured, so can yours.” Gu Jun first gave Xie Yiman hope before telling her about the surgery. As he expected, Xie Yiman’s eyes instantly welled up with tears.

“Listen to me first!” He said quickly, “Atal knows everything and I’m sure he’ll be able to cure your condition but to do that, you have to stay alive! As long as your self-consciousness is intact, as long as you manage to survive the surgery, then there is always a solution to heal your facial injury.” Wu Siyu next to him nodded. “Even though I’ve not met Atal in person, I hear that he looks not one day older than 100 years old even though he is already 300 years old. Clearly, the Great Atal has great experience in beauty skincare.”

‘Was there a difference between how a person looks at 100 years old and 300 years old?’ Gu Jun sighed and nodded, “Indeed, the Great Atal looks very young for his age.”

“But...” Xie Yiman was lost and confused, the small hope was extinguished by a greater despair. Two days ago, she was shooting a movie, she had plenty of shoots lined up, her popularity ensured her stardom and she was going to fight to ensure her star continued to burn... She was aiming for the Oscar, the Golden Globes, to be part of the movie history... But now she would end up prosopoplegic, unable to make simple expressions like turning her eyes or moving her lips...

“No, that can’t happen to me...” Her tears fell endlessly, “What have I done wrong?!”

“You did not do anything wrong, you were just unlucky.” Gu Jun said seriously. Illness was not selective... Although that might not be true in this case. He shook his head and focused, “Yiman, but you are not the only one. There are many people in your line of work who are going to undergo this surgery.” He listed out the names given by Phecda, they were all famous individuals. “Yiman, this is a war that we have to win.”

Even though the tears were still falling, Xie Yiman’s emotion was no longer that haggard. Knowing that others shared in her tragedy did make her feel better... She could not imagine facing this alone. Gu Jun could empathize with that. It was not that we wish illness on others but we hope there was someone out there who could understand what we were going through. Without empathy from others, one would face the illness with loneliness and disquiet, that was too heavy a burden... He did not think Xie Yiman or the girl in his illusion would be able to face a challenge as big as that...

But how can he be sure that was not exactly what the young girl was going through? Still unfound by Phecda, would she know that there were others sharing the same fate as she did? Would she think she was the only cursed one in the world? How would it make her feel about her existence? At that moment, Gu Jun felt a strange connection with ‘Lydia’, it was unclear whether that was a good thing or not.

But no matter what, he would try his best to save Xie Yiman.

“Yiman, I heard from the superiors that Phecda and GOA in the future will set up a new department responsible for public image.” Gu Jun was not lying, that was true, the new department would be modelled after Phecda’s Public Relations Department. “The movies would be all handled by this department. They are looking for directors and actors. Yiman, if you survive this, I’ll be sure to recommend you to join this department. Even with face palsy, one can be a great actor. Have you heard of Takeshi Kitano? Success is still within reach. The important thing is to be alive, anything is possible when one is alive.”

“Yes.” Wu Siyu concurred, “Well said.”

“Doctor Gu...” Xie Yiman sobbed. Of course she felt the two’s concern. She knew they sincerely wanted to help her and hearing those words, she did not feel her future was that dark anymore. But she ultimately could not personally decide to destroy her career....

“I do not understand medicine and much less about supernatural energy...” Xie Yiman scratched at her face. “But I believe in you. Please help me make this decision for you know this better than I do.”

“Okay.” Gu Jun took a deep breath. If surgery was not undertaken, there was definitely no chance for survival. He planned to start with RFL of the trigeminus before moving onto the nervi facialis if the effect was not satisfactory. “Then I need you to be ready. The first surgery will start 2 hours from now. I swear to remove the itchiness once and for all.”