Wang Xiaoqing was not happy.

In the department office, Yang Xu was always going on about how Jiang He was his student, which was so infuriating.

’I finally managed to get Jiang He on my team, and now this kid wants to quit on the very first day?’

’Is that acceptable? Absolutely not!’

Wang Xiaoqing frowned and asked, "Jiang He, are you not planning to participate in the South China Region competition?"

Jiang He replied calmly, "Professor, I do plan to participate in the competition. But I don’t think the advanced prep classes are necessary. I’m currently working on a project that requires me to race against the clock."

What he said was true.

But to the other students in the classroom, it sounded rather jarring.

This was especially true for Xu Chen, who was sitting in the back and had always considered himself the leader among this group of top candidates.

Xu Chen couldn’t help but speak up. "Jiang He, aren’t you getting a little full of yourself? What, we all have to attend the advanced classes, but you don’t?"

Jiang He: "Yeah, I don’t."

Xu Chen: "?"

’I really didn’t expect this. The junior who was so polite at the door just a moment ago... how did he suddenly become so damn cocky?’

’What gives him the right to be so arrogant?’

Pan Wen, standing not far away, quickly lowered his head and pretended to rummage through the notebook in his bag, afraid he wouldn’t be able to suppress his grin.

The truth was, Pan Wen had been annoyed with Xu Chen at the classroom door earlier.

Xu Chen had casually remarked, "This year’s questions were much easier. A lot of them were just basics."

Not only was he subtly putting down Jiang He, but he was also slapping Pan Wen in the face.

If Jiang He only scored a 99 because the questions were easy, then what did that make Pan Wen, who had only scored an 82?

So when Jiang He had politely agreed earlier, Pan Wen had been seething inside.

Now, seeing Jiang He metaphorically slap Xu Chen right back across the face, Pan Wen felt a wave of satisfaction wash over him.

’So satisfying!’

Wang Xiaoqing’s frown deepened.

"Jiang He, the South China Region competition is extremely difficult. I know you’re very capable, but isn’t it underestimating the competition to not even attend the advanced classes? Can’t your project wait until after the competition at the end of the month?"

Jiang He explained, "Professor, this project is on early screening for pancreatic cancer using peripheral blood. Right now, many top international labs are competing in this area. I want to get the data out ahead of them and be the first to publish the results, so I’m racing against time. Time waits for no one."

Hearing the words "international competition," Xu Chen couldn’t help but laugh in exasperation.

He said, "Junior, do you have some kind of misunderstanding about scientific research? You’re just a third-year undergrad. Do you really think you have a chance competing against the top labs in the world?"

Jiang He: "Yeah, I do."

Xu Chen: "?"

As the saying goes, a person shouldn’t get shut down in the same way twice, but Xu Chen had indeed been shut down in the exact same way twice today.

Faced with such an outrageously arrogant answer, Xu Chen silently swore to himself that he would never, ever ask Jiang He a direct question again, in any situation.

’This asshole’s way of answering questions is just too infuriating.’

The classroom was silent for a few seconds.

After a moment of thought, Wang Xiaoqing spoke slowly. "Jiang He, I understand your passion for research. However, I am acting under the orders of the school’s academic affairs office to improve the skills of the students representing us in the competition."

"You are one of our top candidates. If you skip the classes and then fail at the regional competition, I will be held responsible by the school for not teaching you properly."

"So, if you really want to leave, then solve a problem for me."

"As long as you can solve it and then pass my practical skills test, you won’t have to come to these classes anymore."

Jiang He nodded. "Alright."

Wang Xiaoqing quickly took out a sheet of A4 paper. "Let’s start with the first problem. This isn’t from an exam bank. It’s a real case a former classmate of mine from the ER at Affiliated Hospital No. 1 sent me this morning for discussion."

"Listen carefully to the patient’s condition."

"The patient is a 24-year-old female diagnosed with severe acute pancreatitis, or SAP, one month ago. She received conservative treatment at a local hospital. Three days ago, she suddenly developed a high fever of 39.5 degrees Celsius, with worsening abdominal pain. A contrast-enhanced CT scan showed extensive infected pancreatic necrosis behind the peritoneum."

Hearing this, Xu Chen, Pan Wen, and the others quickly ran through the complications of pancreatitis in their minds.

It was difficult to treat, but still within the realm of conventional understanding.

Then, Wang Xiaoqing continued, "In the early hours of this morning, the patient’s condition deteriorated rapidly. She began vomiting large amounts of blood and passing blood in her stool, with an estimated blood loss of over 1,000 milliliters. Her blood pressure plummeted to 70/40, and she went into hemorrhagic shock."

"An emergency angiogram was performed, which revealed that pancreatic fluids had eroded a blood vessel, causing a splenic artery pseudoaneurysm to rupture directly into the digestive tract."

"The diagnosis is very clear: severe acute pancreatitis complicated by infected necrosis and massive hemorrhage from a ruptured splenic artery pseudoaneurysm."

"If you were the attending physician, what would be your next step in the treatment plan?"

The moment she finished, the entire classroom fell silent.

Even Xu Chen, who had been so full of himself just moments ago, was now frowning deeply, his eyes filled with uncertainty.

In the medical landscape of 2008, severe pancreatitis combined with massive hemorrhage had an extremely high mortality rate.

If left untreated, the patient would soon die from hemorrhagic shock.

But the patient’s abdominal cavity was currently full of infected necrotic tissue and pus, and she was in a state of shock.

If they opened the abdomen, the sudden drop in pressure would cause her blood pressure to crash completely. Combined with the spread of the severe abdominal infection, the patient would definitely not survive the surgery.

Opening her up meant death, but not opening her up also meant death.

This was simply not a problem a third-year undergrad could solve.

When Jiang He heard the question, he was momentarily taken aback.

’Why does this case description sound so familiar?’

’Female, 24 years old, severe pancreatitis, infected necrosis, ruptured splenic artery pseudoaneurysm with hemorrhage...’

He quickly racked his brain and remembered.

Before leaving the house today, he had answered a question on "The Garden":

"[Master, can you please take a look at my girlfriend’s case? I’m a medical student too, and I know the situation is terrible, but I want to ask if you have any other ideas. I’m willing to try any solution!]"

The patient’s condition described below the question was identical to what Professor Wang had just said.

He had already answered this question.

So now, he just needed to repeat that diagnosis.

Jiang He said, "The patient is currently in an extreme state of hemorrhagic shock combined with severe infection. A traditional emergency laparotomy for debridement and hemostasis would be too traumatic. The patient’s physiological reserves absolutely could not withstand it. Open surgery is not an option."

Wang Xiaoqing’s eyes narrowed slightly. "If you don’t perform a laparotomy, how do you stop the bleeding?"

Jiang He said, "We can use a step-up approach with minimally invasive therapy."

The strategy he mentioned was actually not published until 2010, in the top-tier New England Journal of Medicine.

This strategy holds a landmark status in the treatment of severe pancreatitis.

Using it in 2008 was, naturally, like bringing a cannon to a knife fight.

After he briefly explained the specific operational procedure...

The classroom was dead silent.

Tang Pei listened, completely stunned.

Xu Chen stood to the side, lost in thought.

’Interventional hemostasis? Percutaneous drainage? Endoscopic debridement? You can do that?’

At the front of the classroom.

Wang Xiaoqing stared at Jiang He, her face full of astonishment.

’How is the plan Jiang He just described exactly the same as the solution my old classmate sent over?’