Dr. Jiang is Pregnant – 30

When Jiang Xu went to the ward, Ma Hao was peeling an orange for Ruan Xiufang. Seeing him arrive, Ma Hao quickly set the fruit aside and wiped his hands with a tissue.

“Doctor Jiang.” He stood up from the small chair by the bed, his gaze a little evasive as he looked at Jiang Xu.

Ruan Xiufang looked much better than before. She had originally been lying in bed, but now she sat up as well, greeting him respectfully, “Doctor Jiang.”

Jiang Xu nodded, not lingering. “Finish your orange first, then come find me to discuss the surgical plan.”

Clearly, neither Ma Hao nor Ruan Xiufang had the mind to eat oranges. Jiang Xu had just gone to call Shao Le and a new rotating graduate student when he saw the couple already standing at his office door.

With a folder in his hand, Jiang Xu waved to them and then led Shao Le and the graduate student into the meeting room.

“Have a seat,” he said to the couple, before opening the folder and addressing the graduate student beside Shao Le. “Xiao Wang, give a brief summary of the case.”

Xiao Wang had clearly prepared in advance. Although he was a little nervous and stumbled over his words, he still managed to cover all the key points.

Jiang Xu gave a quiet “Mm,” and only then did Xiao Wang let out a sigh of relief.

He took the examination results and case reports clipped in the folder and placed them in front of Ruan Xiufang one by one. Seeing Ma Hao craning his neck to get a better look, Jiang Xu pushed the papers slightly toward him so he could see more clearly.

As he laid them out, he gave the couple a general explanation of the situation. By now, both Ruan Xiufang and Ma Hao had calmed down from the initial shock of bad news and listened very attentively. With Jiang Xu replacing difficult medical jargon with simpler terms, Ruan Xiufang was able to understand.

“Doctor, can I really live for a long time?” She had heard Sister Cai’s reassurances and Ma Hao had said it too, but since it concerned life and death, she couldn’t help asking for confirmation again now, looking at Jiang Xu in his white coat.

“In medicine, there’s no such thing as absolute certainty,” Jiang Xu said. “But statistically speaking, the prognosis for early-stage cervical cancer is generally not bad.”

Once the basic details were explained, he got to the main point. “Today I mainly wanted to talk to you about the choice of surgical procedure.”

In Ruan Xiufang’s case, there were two options: a cervical conization or a total hysterectomy. As the names suggest, the former removes only the cervix, while the latter removes the entire uterus.

Ruan Xiufang already had one child, and after confirming she had no further plans for pregnancy, Jiang Xu said, “In this situation, we generally recommend a total hysterectomy. The prognosis tends to be better, and statistically, the chance of recurrence is also lower.”

“A total hysterectomy…” Ruan Xiufang hesitated. “That means I won’t have a uterus anymore?”

“The uterus’s main function is to carry a fetus. Rest assured, it won’t significantly affect your normal life,” Shao Le stepped in to answer.

Ruan Xiufang looked at Shao Le. “But, Doctor Jiang… that cone… cone something you mentioned just now, that would only remove the cervix, right?” she asked, growing a little uncertain again.

“Based on the current preoperative assessment, your condition meets the indications for conization,” Jiang Xu said. “But the risks with conization are greater.”

Put simply, with malignant tumors, as long as the visible mass can be seen, the surgeon can cut it out, but there may still be tumor cells invisible to the naked eye, which could come back and cause a recurrence.

For a non-vital organ like the uterus, total removal is the safest option. This is also one of the reasons the prognosis for cervical cancer is better than that for cancers in other major organs.

Hearing this, Ruan Xiufang fell silent and stopped asking questions, as if she had understood his meaning.

“The current plan is to first perform the radical surgery,” Jiang Xu continued. “Then, afterward, you’ll undergo three rounds of radiotherapy and chemotherapy. The first round will be done here in our department, and after that, Shao Le will arrange for you to be transferred to oncology.” He asked, “Any other questions?”

“Doctor…” Ruan Xiufang’s lips trembled for a long moment before she finally spoke, “I still… want to keep my uterus.”

Jiang Xu glanced at her, drew a line on the document with the pen in his hand, and handed it to her. “Conization will require an additional three rounds of radiotherapy and chemotherapy. The excised tissue will be sent for intraoperative pathology. If the margins are positive, that is, if there are traces of tumor cells, you’ll still need to undergo a total hysterectomy.”

If the surgical margin is positive, it would indicate invasive carcinoma, which would require redefining and reassessing Ruan Xiufang’s cancer staging. If the situation turned out unfavorable, she might also need further lymph node dissection and bilateral adnexectomy.

Ruan Xiufang shook her head. “But Doctor…” she hesitated. “Without a uterus, I’m not a woman anymore.”

Jiang Xu’s eyelashes gave the faintest, almost imperceptible tremor.

This time, before Jiang Xu could speak, Ma Hao spoke up first. “Oh, come on, wife, your life is the most important thing, no matter what. If you’re gone, what use is a uterus? Whoever dares say you’re not a woman, I’ll beat the crap out of them.”

Jiang Xu, pen in hand, gave Ruan Xiufang another look.

“It’s the estrogen in your ovaries that mainly maintains your secondary sexual characteristics,” he said. “If things go well during surgery, we’ll do our best to preserve your ovaries.”

“That’s not the same, Doctor.” Ruan Xiufang’s voice was heavy with distress. “I feel awful inside. If removing it was absolutely necessary to save my life, then fine. But right now, clearly, we don’t have to remove it. I’m willing to take that risk.” She added, “I can’t be the only one who’s had this surgery. What are the odds I’d be so unlucky as to have a recurrence?”

Jiang Xu nodded at her words, then went over all the precautions and the pros and cons of both procedures again. “You can go home and talk it over. When I do my rounds tomorrow morning, you can give me your decision.”

With that, he closed the folder, tucked the pen into his breast pocket, and left the meeting room.

The graduate student, Xiao Wang, followed behind Shao Le. He hadn’t been here long, but he knew Jiang Xu’s reputation for strictness, so he didn’t dare ask him directly. Instead, he lowered his voice to Shao Le beside him. “Sister Shao Le, Professor Jiang just left like that? He’s not going to try to persuade her again?”

Shao Le shook her head. She remembered when she’d first arrived, she’d had the same question. Jiang Xu had simply told her that as long as you’ve clearly explained what needs to be explained to the patient, that’s enough. Something like a uterus, you might think it’s not important, but you can’t deny that to some people, it matters greatly. Everyone’s needs are different; as a doctor, you must never judge others by your own standards. The patient’s needs should always come first.

Especially with a disease like cancer, which is so closely tied to mental and emotional health, for someone like Ruan Xiufang, who’s so resistant to the idea, even if you perform a total hysterectomy for her safety, she might end up depressed, which could actually make recurrence more likely.

She still remembered years ago when Jiang Xu treated an elderly lady with vaginal condyloma acuminatum. Everyone else assumed that at her age, scar reconstruction wouldn’t matter much and didn’t take it seriously. Only Jiang Xu thought to ask if she still had a need for sexual activity in the future. To everyone’s surprise, the gray-haired lady nodded. The surgical team had to urgently change the procedure.

Most people are quick to judge others based on their own feelings or conventional thinking, but everyone is different. The most important thing a doctor can do is consider the patient’s own needs.

She softly recounted these past events to Xiao Wang, who nodded thoughtfully, his gaze falling on Jiang Xu’s tall, slender figure ahead.

In Jiang Xu’s mind, Ruan Xiufang’s offhand remark kept circling. Rarely for him, he found himself distracted, not hearing what they were saying. He returned to his desk, set down the folder, and took a sip of water. The water had been sitting too long and was slightly cool, so he topped it up with hot water, took a couple more sips, and felt an unusual weariness settle over him.

Even though the baby was only three months old, carrying him around all the time was still heavy. He rubbed his sore lower back and sat in the chair for a while, gaze unfocused. He stayed there a long time, until he’d regained enough energy to get up and head to the parking lot to drive home.

When he got home, he slid the key into the lock, intending to turn it twice out of habit, but the door opened after just one turn. Seeing the living room lights on, he belatedly remembered that there was now another person living here.

The feeling was a bit new, even strange.

It seemed like it had been a very long time since he’d last opened a lit doorway at home.

Shen Fangyu was in the middle of a video conference. He gave Jiang Xu a brief nod when he came in, removed one side of his headset, and, after confirming Jiang Xu had nothing to say to him, put it back on and returned his attention to the computer screen.

When he was working, his expression was highly focused, speaking from time to time. Jiang Xu listened, it sounded like he was guiding a student’s research project.

In truth, this was Shen Fangyu’s usual state. It was just that his clownish, playful side had been so prominent lately that seeing him like this suddenly felt almost unfamiliar.

Pushing aside that faint, subtle feeling, Jiang Xu set down his bag, changed into slippers, and headed to the bathroom to shower.

Scalding hot water pounded down on him, filling the air with milky white steam that blurred his vision.

A whole day’s worth of surgeries, bloodied organs, wailing infants, a fine from the administration office, soup gone cold and reheated, the faces of Ruan Xiufang and Ma Hao, and that glance from Shen Fangyu just now when he’d removed his headset.

A jumble of images flickered past in his mind like a rapid slideshow, shadowy and surreal.

For some reason, he suddenly felt overwhelmingly tired.

Standing before the mirror drying his hair, Jiang Xu used his other hand to wipe away the thick layer of condensation, revealing his own reflection.

Though he’d never paid much attention to his own looks, he still noticed that he’d grown thinner, his cheekbones more defined than before, the lines of his jaw especially sharp.

As if compelled by some impulse, his hand kept wiping downward on the glass until the mirror showed his full upper body.

Whatever it was he saw, Jiang Xu’s hand suddenly slackened around the hair dryer. It fell to the floor with a thud, the plug jerking from the socket and sending a small crackle of sparks into the air.

The noisy hum of the dryer abruptly ceased, and the bathroom fell silent. From the living room, he heard a voice call out:

“What just fell?”

Jiang Xu didn’t respond. His half-damp hair clung to his scalp, droplets of water still clinging to the ends.

He lowered his gaze, the steam dampening his eyelashes until they appeared especially dark, like ink. His eyes fell on his own lower abdomen in the mirror, his expression unreadable.

The child, now over three months along, had already given his belly a faint curve. It wasn’t noticeable when he was dressed, but with his upper body bare like this, there was nowhere to hide it.

Ruan Xiufang’s offhand remark echoed in his mind again, the sigh of a woman still lingering in his ears.

“Without a uterus, I’m not a woman anymore.”

Then… with a uterus?

Jiang Xu looked into the mirror.

“What am I?”
Since confirming his pregnancy, it was the first time he had asked himself this question.

It wasn’t that he’d never thought about it before, only that every time such a thought even began to sprout, he would crush it immediately, not daring to dwell on it for even a moment. He even deliberately avoided looking at his changing belly in daily life.

But this time, perhaps because he was too exhausted, or because Ruan Xiufang’s words had quietly torn open a fissure in his heart, the emotions he had kept suppressed for so long suddenly came pouring out. He could no longer hold them back and finally asked himself.

What am I?

Jiang Xu stared at the man in the mirror, too afraid to answer.

In the silence of his standoff with his own reflection, a stray, unanchored thought suddenly surfaced in his mind.

If Shen Fangyu were here, he would probably grin and tease him a couple of times, mock his poor tolerance for pressure, then, wearing that hint of irreverent, careless smile, smash this mirror without a second thought.

So Jiang Xu did exactly that.

With a sharp crack, the mirror before him shattered into pieces, some shards clattering to the ground, others clinging to the frame, webbed with countless cracks.

Jiang Xu glanced at his bleeding hand, then at his own fragmented face in the mirror.

And in the depths of the silence, he heard the sound of footsteps, unexpected, drawing nearer from far away.

In sync with his heartbeat, one step after another, they grew clearer and clearer.