(Thanks to mangmangliu and reader 20170118000422617 for their support with voting)

Liu Banxia was a bit troubled because, for him, he has a bit of obsessive-compulsive disorder. But today's young patient's condition was not something he could solve.

In his heart, he believed the young patient was indeed ill, but he had no idea what exactly was causing the current symptoms.

This was what troubled him a little. Regardless of whether it could be treated, at the very least, the cause of the illness must be determined first.

"Teacher Liu, Teacher Xu has invited you for a consultation." At this time, Su Wenhao walked over.

Liu Banxia nodded and followed him to the internal medicine clinic.

As soon as he entered, Liu Banxia frowned. The patient's condition was not good.

The patient was lying on the examination bed, with a distinctly prominent protrusion on the abdomen.

"There's a huge tumor in the abdomen that's already pressing on the internal organs, see if it can be removed," Xu Hui said.

"This is tricky." Just by looking at the film, Liu Banxia's frown deepened.

The tumor was really large, squeezing the stomach, intestines, liver, and seemingly pressing against the diaphragm, compressing the heart.

The patient and family in the ward were also looking at Liu Banxia. From Xu Hui's introduction, they were expecting a very skilled surgeon to come.

"From the staging, it should be around stage two, it hasn't caused significant invasion to the surrounding tissues and blood vessels," Liu Banxia said.

"But this tumor is too large, probably three to four pounds, and is surrounded by so many organs, making its removal very difficult and the surgery high-risk."

"About two years, this past half year it's grown faster and already affecting liver function," Xu Hui said.

"They did a round of chemotherapy at their county hospital, but it was ineffective. The tumor grew larger post-chemotherapy, and the person couldn't take it anymore."

"Conservative treatment methods are no longer viable, feel free to discuss any thoughts you have with them; they've mentally prepared for everything."

"Let me take a closer look." After saying this, Liu Banxia began examining closely.

Not just the film, but also the ultrasound and other tests.

After looking for more than half an hour, Liu Banxia rubbed his brow and sat across from the patient and family.

"How is it?" Xu Hui asked.

"This surgery is very challenging, with an inferior vena cava tumor, but it has pushed all the abdominal organs to one side and is enveloped by the liver," Liu Banxia said.

"The position is quite awkward; even if the thoracic cavity is opened up, the surgical field provided isn't much, increasing the risk of tumor spreading to the lungs."

"The tumor is too large. The only method I can think of now is an autologous liver transplant operation. And I can't do it; the director will have to perform it."

"Doctor, what kind of surgery is this? Is it a liver transplant? My dad surely can't wait, and we don't have that kind of money," the patient's son said anxiously.

"It's a type of liver transplant surgery, but it's about removing his liver, removing the tumor attached to it, and then transplanting the healthy liver back," Liu Banxia said.

"It will also be a combined surgery where we need to remove that section of the inferior vena cava and perform an artificial blood vessel transplant. The only good news so far is that this tumor doesn't seem to involve the kidney."

"This plan is currently the most suitable surgical plan I can think of for your father's current condition. Of course, this surgery is also very risky."

"Post-surgery could potentially result in bile leakage, bleeding, small-for-size syndrome, pulmonary edema, lung infection, acute liver failure, and in-surgery is also very dangerous, due to liver ex vivo time, possibly causing cardiac arrest."

"Many complications possible during surgery are likely in this procedure. The tumor inside him is so large, compressing surrounding organs and blood vessels, causing some functional impacts."

"If we remove the liver and tumor simultaneously, the function of these organs might change, affecting overall body metrics."

"Furthermore, post-operation requires long-term care and chemotherapy. This is the only solution I can think of for now. Otherwise, we'll continue with conservative treatments and see if the tumor can be reduced."

The patient and family fell silent, though they were still not very familiar with the surgical procedure they understood the gist. It's about taking the liver out, removing the tumor, and putting the liver back.

Such a high-risk surgery isn't just about removing the tumor.

But the choices they had left, just as Liu Banxia said, were either to go back for conservative treatment, which was essentially waiting for death, or to agree to this highly dangerous surgery, taking a gamble.

If successful, he could live a few more years. If not, nothing is gained but loss.

"Doctor Xu, let them consider it first. If they agree, I'll report it to the director. The difficulty of this surgery is too high; it can only be done by the director," Liu Banxia stood up.

"Alright, I'll contact you if there's any news," Xu Hui said.

Actually, he thought this surgery couldn't be done. Calling Liu Banxia was just a shot in the dark. Unexpectedly, Liu Banxia actually figured out a way, although the risk remained high.

"Teacher Liu, this surgery is a big deal," Su Wenhao said after stepping out.

"Yes, from current tests, it seems the kidney won't be affected, but the actual situation can only be understood after the abdomen is opened," Liu Banxia replied.

"Moreover, the patient has undergone chemotherapy before, and their current physical parameters aren't well, which is a significant challenge for the anesthesiologist."

"Additionally, this surgery is quite expensive. Even if part of it can be covered by insurance, it's uncertain if they can afford the remaining costs."

"The patient is expected to stay in the ICU for about a week, and there will definitely be some degree of infection post-operation. Transferring from ICU to a regular ward might take another 7-10 days before discharge."

"And that's if everything goes smoothly. The patient might not even make it off the operating table. Let them make the choice; it's not like an appendectomy where we can provide suggestions and references."

Su Wenhao nodded, understanding why Liu Banxia hadn't said much earlier.

He learned a new lesson, realizing he needed to consider not only the patient's medical condition but also their overall situation.

This surgery can be performed because it has a certain success rate, and it will certainly be approved, especially with Zhou Shuwen as the chief surgeon. But the unavoidable fact is that the patient might not make it safely off the operating table.

In that case, it would be a disaster for the family. Money spent, life lost.

If it were a wealthy family, they wouldn't need to think twice. Money wouldn't matter; life is the most important thing.

But for an ordinary family, money truly matters. It's not just a matter of thousands; it's hard to predict how much it will cost.

Like Liu Banxia mentioned, post-surgical infection in such a major surgery will undoubtedly result in complications, and controlling these complications also requires money.

Liu Banxia rubbed his face, feeling that today's two cases were quite tricky. Was this how they welcomed him as the new deputy director? This was a bad joke.

He looked up to see Zhou Shuwen in his office, and after pondering for a moment, he decided to walk in directly.

Since he wasn't very confident about the surgical plan he proposed to the patient, he needed Zhou Shuwen's help to review it.

"What's up? Something wrong?" Seeing him enter, Zhou Shuwen asked with a smile.

"Director, internal medicine just consulted me on a very difficult case. I've temporarily proposed a plan. Do you have time to give me some feedback?" Liu Banxia said.

Zhou Shuwen nodded and put down his pen.

Liu Banxia quickly approached, pulling up the patient's data he'd just memorized on the computer.

"It's massive, and the patient is somewhat old, fifty-three years old, which is a bit risky. The only option is an autologous liver transplant to provide enough space for the operation. However, the right kidney seems to be in the way as well; hopefully, it won't have to be removed," Zhou Shuwen said after looking it over.

"Director, that's exactly what I suggested to the patient, but you'll need to perform the surgery, and I'll just observe," Liu Banxia quickly replied.

In his heart, he truly admired Zhou Shuwen; he'd spent a long time coming up with the plan, while Zhou Shuwen figured it out in just a few minutes.

That's experience, something Liu Banxia currently does not possess.

Although Liu Banxia can hone his surgical skills with the help of his dream space, he cannot match Zhou Shuwen in terms of the number of patients treated.

"Not confident? But you're about to be given surgical permissions," Zhou Shuwen commented.

Liu Banxia nodded straightforwardly, "Not confident at all. After seeing full abdominal organ transplants before, I thought they were actually quite simple."

"But after the giant cardiac myxoma and autologous heart transplant last time, I realized organ transplants are indeed very difficult."

"In this patient's case, without those two transplant experiences, I would still be figuring out how to remove it directly."

"Might have ended up just cutting open, doing whatever possible, and ultimately needing a liver autotransplant anyway. That would be very risky; not many in our hospital can perform such a surgery, and they're all quite busy."

Zhou Shuwen nodded in satisfaction, "Good, you can calm down, and that's progress. Otherwise, you never know when you might make a big mistake."

Liu Banxia grinned sheepishly. In the past, he might have really rushed into things.

Back then, he thought with the system supporting him, there wasn't a surgery he couldn't perform, but the reality is far different. Recently, he's been able to see some of his shortcomings.

This is progress.