That afternoon, Zhaxi went to find his two roommates again and told them what Yang Ping had said.
"Missing a link?" Bilige, the roommate from Inner Mongolia, frowned. "Which link?"
Ely from Xinjiang thought for a mont and said, "Stool sample? But the Patient isn’t having diarrhea now, what do we do?"
Zhaxi said, "We can’t just wait for him to poop, right? What if he doesn’t go for ten days or half a month, and the aneurysm blows in the anti?"
The three of them fell silent for a while.
Suddenly Bilige said, "How about we ask if we can use a rectal swab?"
"Rectal swab?" Ely asked.
Zhaxi said, "You use a cotton swab to take a sample from the anus, you don’t need to wait for stool. So Hospitals test for Clostridioides difficile that way."
Bilige’s eyes lit up. "That’s a good idea."
Ely said, "But we have to talk to Professor Yang first, we can’t just ss around on our own."
Zhaxi nodded. He had made up his mind.
On Friday morning, Zhaxi arrived at the Hospital at six.
At exactly seven, Yang Ping ca. Seeing Zhaxi, he raised his eyebrows. "So early?"
Zhaxi took a deep breath and laid out his idea about the rectal swab.
After listening, Yang Ping smiled, said nothing more, pushed open the office door, and said, "Let’s go, to the Overseas Chinese Building."
That morning, after Yang Ping’s discussion with them, the family agreed to a rectal swab test. The sample was sent, and they would have to wait two days for the result.
Walking out of the Overseas Chinese Building, Zhaxi’s heart was in his throat. What if the result was negative? What if his suspicion was wrong?
Yang Ping seed to see right through him and said, "Don’t overthink it. If it’s negative, there’s a way to work it up for a negative; if it’s positive, there’s a way to treat a positive. Clinical work is like this—you move forward step by step."
Zhaxi nodded, but he was still nervous inside.
Two days later, the result ca back: Clostridioides difficile toxin positive.
When Zhaxi saw the report, his hands were shaking.
Holding the report, Yang Ping said to Director Tian and Doctor ng, "Treatnt plan: oral vancomycin for two consecutive weeks, monitor electrolytes at the sa ti, continue potassium and sodium supplentation, leave the aneurysm alone for now, repeat Angiography in two weeks."
Doctor ng looked stunned, but he didn’t ask anything. He just nodded and went to write the orders.
Standing behind Yang Ping, Zhaxi held back for a long ti, then finally asked the question he’d been holding in for two days: "Professor Yang, when did you first start suspecting Clostridioides difficile?"
Yang Ping turned and looked at him. "The first ti I ca for the consult."
Zhaxi froze. "The first consult? Then why didn’t you order the test right away?"
Yang Ping said, "Because I had no evidence. Suspicion is suspicion; diagnosis is diagnosis. I can’t order a test for a Patient just based on suspicion. I needed more clues, needed the family to cooperate, needed to rule out other possibilities." He paused and looked at Zhaxi. "Do you know what’s hardest?"
Zhaxi shook his head.
Yang Ping said, "The hardest part is, when you have a suspicion, to sit tight and look for evidence step by step, not to rush to a conclusion, and not to let any doubt slip by."
When he finished, he patted Zhaxi on the shoulder. "You did well this ti. Keep it up."
A feeling he couldn’t quite na welled up in Zhaxi’s chest.
He knew this was only the beginning. The chain of evidence had just been closed; the real treatnt hadn’t yet begun.
And that aneurysm was still in the Patient’s Brain, like a Ticking Ti Bomb waiting to be defused, ready to explode at any mont before it was taken care of.
Two weeks later, the Patient underwent repeat cerebral Artery Angiography.
Standing at the door of the reading room, Zhaxi clutched the chart in his hand, his Heartbeat twice as fast as usual. He didn’t even know why he was this nervous. It wasn’t him doing the Surgery, and it wasn’t even his Patient. But having followed this case from the beginning, it felt like it had taken root in his heart; every night he had to take it out and go over it once.
Inside the reading room, Yang Ping was already standing in front of the light box. Doctor ng was clipping the films onto it, his hands also trembling a bit. What if the aneurysm was still there? What if it had gotten bigger? What if these two weeks of antibiotics had all been for nothing?
The films went up one by one.
Right middle cerebral Artery, distal branch.
Zhaxi stepped closer.
The aneurysm that had once been 8 mm was gone.
At the original site, the vessel wall was smooth, blood flow unobstructed, with no outpouching, no stenosis—like nothing had ever grown there at all.
The reading room was silent for quite a while.
Doctor ng took off his glasses and rubbed his eyes, then put them back on and leaned in toward the light box, his nose almost touching it. "Dis... disappeared?" His voice had gone up in pitch.
Standing beside him, Director Tian was just as incredulous—an aneurysm had simply vanished like that.
Yang Ping stood behind them, his face expressionless, only giving a slight nod.
Zhaxi stared at the light box, his mind a complete blank. He had worked as a Doctor in Changdu for five years. He’d seen aneurysm Surgery, he’d seen endovascular coiling, but he had never seen an aneurysm disappear on its own. On the Operating Table, doing open Surgery to clip it or endovascular coiling—those were ways of defusing the bomb. But now? The bomb had vanished on its own? The Blood Vessels had healed themselves?
"Professor Yang!" Doctor ng turned around, his voice carrying a kind of reverent awe. "How were you so sure? Two weeks ago, when you told to start vancomycin, I didn’t say anything out loud, but inside I was really on edge. What if it wasn’t an infection? What if the aneurysm ruptured? What if..."
Yang Ping cut him off. "Are you still on edge now?"
Doctor ng was taken aback, then shook his head. "No."
Yang Ping said, "Then that’s fine." He turned and looked at Zhaxi. "You understand now?"
Zhaxi nodded, then shook his head. "I see it, but I don’t fully get it. How can antibiotics make an aneurysm disappear?"
Yang Ping walked up to the light box, pointed at the Angiography film, and said, "This isn’t an ordinary aneurysm. A typical aneurysm forms when the vessel wall is subjected to long-term blood flow impact, gradually thinning and bulging, like blowing up a balloon. For that kind of aneurysm, antibiotics are useless—you can only treat it with Surgery, otherwise the thinned part will rupture sooner or later."
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