Chapter 13: Chapter 13: This Is the Dimensional Reduction Strike a Reincarnator Should Have

The wind was indeed strong today. The library’s curtains were all billowing.

Jiang He went and closed the windows one by one. Then he returned to his seat and began studying past exam questions.

For the medical students of this era, these questions were quite difficult.

For example, a question from ’06: "A case of unexplained abdominal pain with jaundice, ERCP shows stenosis in the lower segment of the common bile duct. How do you differentiate between sclerosing cholangitis and cholangiocarcinoma?"

The standard answer required a list of imaging characteristics, tumor markers, and the limitations of brush cytology.

’But Jiang He knew a more precise answer: measure IgG4 levels to rule out autoimmune pancreatitis, and use endoscopic ultrasound-guided fine-needle aspiration as the gold standard.’

’But he couldn’t write that...’

In 2008, the concept of IgG4-related diseases was just getting started in China, and EUS-FNA was only available at a handful of top hospitals.

’Writing any of that would be a dead giveaway.’

He had to force his mind back, to think within the limitations of the current era.

’It was like trying to solve an elementary school math problem and being forbidden from using calculus or trigonometry...’

After a full morning of research, Jiang He opened his notebook and glanced at the gift he’d prepared for his visit to Professor Yang Xu:

*A Discussion on Improved Radical Resection for Hilar Cholangiocarcinoma*

’Truthfully, Jiang He hadn’t done much research in this area himself. He was simply giving his future mentor the results of his research from his past life, just a little ahead of schedule...’

To put it simply, in 2008, many surgeons performing resections for high-level cholangiocarcinoma would often not resect the caudate lobe at all, or only partially resect it.

In reality, however, without a total caudate lobectomy, the postoperative recurrence rate was extremely high.

Therefore, Jiang He’s paper focused on articulating a bottom-up, retrograde resection method.

It also detailed how to safely manage the short hepatic veins without clamping the portal vein.

’Many of these technical details were lessons learned the hard way, paid for with countless painful failures in the years to come...’

SCRAPE—

The sound of a chair scraping came from beside him.

Jiang He turned his head to see Chen Hao sit down, holding his school bag.

"You made it?" Jiang He asked.

"Yeah."

Chen Hao pulled a copy of *Surgery* from his bag.

He flipped it open to the Chapter on pneumothorax and stared at the anatomical diagrams.

Jiang He didn’t disturb him, continuing to organize his own notes.

When they went to grab lunch, Chen Hao said, "Old Jiang, about that injection yesterday... how did you have the guts to do it?"

"What about it?" Jiang He asked.

"I was just reading about the complications. Hemopneumothorax, mediastinal emphysema, cardiac tamponade... any one of them could kill someone..."

He looked at Jiang He, his eyes filled with a hint of lingering fear.

"I used to think those were just words to memorize for an exam," he said. "But after yesterday, I realized there’s a human life behind every single one of them."

Jiang He looked at him, feeling he had matured quite a bit. "Are you scared?" he asked.

"I am," Chen Hao admitted with a nod. "I had nightmares all night after I got back. I dreamed that the needle missed and blood sprayed all over the floor."

He paused and took a deep breath. "But, Old Jiang, then I thought, what if I knew what I was doing, like you? Wouldn’t that person have had an even better chance?"

Jiang He smiled. "So, no raiding today?"

"Nope."

Chen Hao shook his head. "I told my guildmates they can have both of our accounts to level for now. I’ve been thinking. ’You’ll regret how little you know when you need knowledge most’—that shit isn’t just some empty saying."

"I used to think being a doctor was just a job. You know, get the diploma, go back to the county hospital in my hometown, and that’s your life."

"But yesterday... watching that man come back to life, hearing him gasp for air... my heart was pounding. It felt better than getting a server-first kill."

"Old Jiang, I want to be the one who can step up and save someone next time, just like you did."

Jiang He patted his shoulder. "Okay. Let’s study hard together."

"Yeah." Chen Hao nodded emphatically, then grinned. "Oh, by the way, it wasn’t just me. Old Wang and Li Zijian got fired up too."

"Oh?"

"After you left, Wang Bo immediately started hitting the books. He said the former number-one student in the dorm can’t afford to be left in the dust. He’s got too much face to lose."

"Li Zijian’s reaction was even better. He said he saw a bunch of girls on the campus forum asking who the hero was. He quoted one of them: ’Turns out knowing how to save a life is even more attractive than looking like Daniel Wu.’ Now he’s sworn to master first aid for the sake of his future wife..."

Jiang He chuckled, speechless.

’Whether it was for responsibility, for pride, or for girls... as long as they were willing to study, it was a good thing.’

"Oh, right," Chen Hao said. "I bought the clothes. They’ve been shipped, so they should be here in about three days."

Jiang He: "Thanks."

"Don’t mention it." Chen Hao slung an arm around his shoulder. "Come on, let’s go eat."

...

「Afternoon.」

Back in the library, Jiang He took out a fresh sheet of A4 paper.

’The competition, Professor Yang Xu—he had a handle on both.’

’Now it was time to work on his own problem.’

’Using targeted therapy directly was unrealistic, and gene sequencing was too expensive.’

’He had to find an angle that would work with the resources available in 2008.’

After a moment’s thought, Jiang He wrote a title on the paper:

[A Clinicopathological Analysis of the Relationship Between Pancreatic Cancer Lymph Node Ratio (LNR) and Prognosis]

’This research topic was actually quite shrewd.’

’In 2008, it was a field completely overlooked by the heavyweights in medicine.’

’The medical community at the time was in a frenzy over gene sequencing and molecular targets.’

’It was as if it didn’t count as ’real’ research unless you burned through hundreds of thousands in funding and did something at the microscopic level.’

’But LNR—the lymph node ratio—was different.’

’All it required was patience.’

’You just had to go to the pathology department’s archives, pull the medical records from the past five years, and then re-compile and clean the data.’

’Once the data was processed, it would be enough for a publication.’

’What’s more, it would directly lead to a revision of the existing TNM staging standards.’

’It would be a message to every surgeon out there—’

’Listen up, boys. Your resections haven’t been wide enough. You need to go bigger!’

’A zero-cost investment and an incredibly simple concept in exchange for a Q1 SCI paper that would make even Professor Yang Xu slam his fist on the table in approval.’

’Simple, elegant, and perfectly suited to his current status as a student.’

’This was the kind of overwhelming advantage a reincarnator ought to have...’

"Are you drawing?"

Cheng Xiyao, who was sitting across from him, suddenly spoke.

Jiang He snapped out of his thoughts and realized he had subconsciously sketched a rough anatomical drawing of a pancreas in the corner of the page, circling the uncinate process.

"Yeah, just doodling," Jiang He said, flipping the paper over.

Cheng Xiyao looked at him curiously. "That’s a pancreas, isn’t it? You seem really interested in it lately."

"I guess you could say that."

"Why?" Cheng Xiyao asked, confused. "Everyone says the pancreas is a surgeon’s nightmare. It’s difficult to treat and has a poor prognosis. Unless you’re trying to become some famous surgeon, it’s better to go into orthopedics or ophthalmology."

Jiang He was silent for a couple of seconds. "What if I do want to become a famous surgeon?"

"Oh..." Cheng Xiyao said awkwardly. "Well... that’s great..."

Jiang He sighed.

’Looks like the library isn’t a peaceful place to study either,’ he thought. ’I keep running into Cheng Xiyao.’

’The girl talks too much.’

’Besides... if Teacher Shen found out he was studying with a girl every day, he’d never hear the end of it.’

’Time to find a new study spot.’