Sunday, evening.
Jiang Xu sat in Tang Ke’s office, one leg crossed over the other, still immaculate in his gray-and-white striped shirt.
In front of him was a thick stack of medical reports, with only the names blurred out.
It was clear that his state of mind had stabilized a lot.
But… Tang Ke couldn’t shake the feeling that Jiang Xu didn’t look like someone who had come to terms with it, he looked more like a patient who had been diagnosed with a terminal illness and had now reached a kind of lifeless calm.
Still, what needed to be said had to be said, “Here’s the situation. We’ve ruled out any malignant tumors. There’s definitely a gestational sac in your abdomen, about two months along,” Tang Ke explained. “I told you my hypothesis when we did the color Doppler ultrasound this morning. Now, combined with the other test results, I’m pretty sure I was right.”
He gestured with his hands as he spoke, “It’s probably due to a developmental mutation in the mesoderm cells. The paramesonephric ducts didn’t fully regress and instead developed abnormally within your body cavity, forming a uterus and bilateral adnexa. Between the cervical opening and the intestines, there’s a very thin soft duct. My preliminary guess is that this is because the sinus tubercle on the posterior wall of the urogenital sinus adhered to the wall of the primitive gut.”
Tang Ke frowned slightly. “Based on the test results, it seems that only about two to three months ago did your uterus and adnexa become active. Luckily, they developed late, so the impact on your body isn’t too severe. But regardless of whether you want this child or not, we’ll still need to perform a hysterectomy with bilateral adnexectomy. Those organs shouldn’t even be in your body in the first place. If your non-steroidal hormones become disrupted, it’ll be a big problem.”
He spread his hands. “I don’t need to tell you this, you’re a doctor yourself. You know it better than anyone.”
Jiang Xu finished going through the reports one by one, then interlocked his fingers and rested them on Tang Ke’s desk.
“Are you planning to keep it?” Tang Ke asked.
Jiang Xu stared at the mahogany surface of the desk for a long while, almost as if his mind had gone blank.
“I don’t want it.”
Tang Ke nodded in understanding. Even though Jiang Xu had always seemed mentally strong, he was still a man. Simply coming to terms with being pregnant must have already drained him mentally and emotionally. Not wanting the child was the normal, rational choice.
“Can you calculate how far along it is?” he asked.
An ultrasound could give an estimate based on size, but it wouldn’t be precise.
“Sixty-five days,” Jiang Xu answered without hesitation. He flipped open a calendar. “Past forty-nine days. A medical abortion isn’t an option anymore.” He had already done the math himself.
That caught Tang Ke off guard. “So, your sex life with your boyfriend isn’t exactly… active, huh?”
With the far more shocking fact of the pregnancy in front of him, he had easily accepted that Jiang Xu’s partner was a man. For him to be able to pinpoint the timing so precisely, it could only mean it happened once during that period.
Jiang Xu didn’t respond to his teasing. “The soft duct is less than 0.5 cm in diameter, and the angle where it meets the intestines is too small. Suction aspiration isn’t feasible.”
He had already gone through every possible surgical method in his head. He knew better than anyone: “It has to be laparoscopy or open surgery.”
Tang Ke nodded. “Laparoscopy’s still possible for now, but wait a few more months, and it’ll have to be open surgery.”
Even though Tang Ke didn’t perform surgeries himself, he knew that open surgery came with more risks and greater long-term complications. In an era dominated by minimally invasive techniques, an open procedure was considered major surgery, with a significant impact on the body.
“But I do have some good news,” Tang Ke said. “This whole thing had me so rattled these past couple of days that I reached out to some friends, and… I actually found something.”
Tang Ke picked up his tablet, tapped on the screen, and handed it to Jiang Xu.
“I have a friend who works as an editor for an international journal. Last month, there was a paper submitted that described a case very similar to yours. The author is from Country M. The article hasn’t been published yet, so my friend can’t send it to me, but I do have the author’s contact information. If you need it, you can email him and see if he’s willing to help. But in his case, the patient carried the child to term. He performed an open abdominal cesarean section, and both father and child were safe.”
Jiang Xu’s eyelashes trembled slightly.
Just as Tang Ke said, this really was good news.
Having a reference case, no matter how small, was vastly different from having nothing at all. It might seem like a drop in the bucket, but for a doctor, it made all the difference.
Surgery wasn’t just about fixing whatever was broken. Jiang Xu knew this better than anyone. Every procedure he performed was something he had first observed countless times from his seniors, memorizing every step and reciting human anatomy as if it were second nature, before daring to operate under a mentor’s supervision, practicing until it became second nature.
He could challenge himself, but he could not gamble.
Modern surgery had developed over two centuries, built on countless lives lost and oceans of patients’ blood, until it had finally reached the level of maturity it had today.
Innovation often came with sacrifice. For the vast majority of doctors in the world today, medicine was more a process of inheritance and study than one of trailblazing.
With enough supporting data, new treatments could be gradually developed. But no one would dare attempt a brand-new, unprecedented surgery on a whim.
Yet male pregnancy surgery was just that, unprecedented. Other than that one case in Country M, there wasn’t a single reference to be found in any medical text or literature. Its occurrence was rarer than the rarest of diseases.
And this wasn’t just about removing the child. The procedure would also require removing the uterus and both adnexa, and this was all inside a male body. One could hardly imagine how complex the blood vessels and tissues would be once the abdominal cavity was opened.
No experience meant enormous risk.
“Jiang Xu, if you’ve decided to terminate, I think the safest bet is to contact the lead surgeon from that paper, Dr. Kenn. He’s at least performed a full-term case and has some experience. But right now, getting a visa to Country M isn’t easy. You might be able to wait, but the baby can’t.”
Given the current global political climate, the situation was uncertain. Even in the best case, it would take at least three months to get there. By then, the fetus would already be five months old.
At five months… it would already have memory and could even recognize the voice of the one carrying it.
Tang Ke hesitated, then added, “Actually, I think… if you and your partner are in a good place, it wouldn’t hurt to wait a little while and see how things go. This might even be fate. There are so many same-sex couples who would give anything for a child of their own,” he said. “This way, you’d also have around eight months to contact the doctor and prepare for surgery, which would take some of the pressure off.”
Jiang Xu clasped his hands together in front of his knees. “I still prefer to do it now.”
Tang Ke sighed. “The problem is, even if you’re ready, who’s going to perform the surgery for you?” He paused. “Who in this country would dare to take on a procedure like this?”
No one had ever done it before. No one had any confidence. No one was willing to risk both their career and Jiang Xu’s life.
“If I could get my hands on a surgical video, I might be able to find someone,” Jiang Xu said.
“That depends on how much that doctor in Country M is willing to share,” Tang Ke replied. “After all, aside from him, no one else in the world has ever done this kind of surgery.”
“Actually… there is,” Jiang Xu suddenly said. But then, he didn’t continue.