Ning carried the treatment estimate to the infirmary window the next morning. Yan walked beside her with the medicine jar and a folded copy of the shift map. He let her set the pace. She stopped once on the stairs to breathe, then continued when she was ready.
Physician He met them in a small room behind the dispensing counter. Ning placed the estimate on his desk and sat without waiting for Yan to explain it.
“I want to know which parts are necessary now,” she said. “The refinery vents make my breathing worse. I can’t keep paying for the full package at once.”
The physician reviewed the examination note. “The lung-clearing course is the fastest option. It is not the only one. A measured inhalation treatment and a reduced-exposure work station can help more gradually.”
“What does that cost over a month?” Yan asked. “The broth, inhalation herbs, and follow-up visits?”
Physician He turned a slate around and wrote each item separately. The inhalation kit required a deposit, then less for the weekly herbs. The follow-up visits carried a small fee. The broth could continue as a comfort measure but would not replace the treatment.
Ning read the figures. “If I change from Furnace Three to the east line, I can keep the same number of workdays?”
“Your pay may be lower if the station has fewer hours. The steward decides who moves. I can write that exposure worsens your symptoms and that a lower-vent station is recommended.”
“Please do. I’ll take it to the steward myself.”
Yan looked at the total. The cheaper course fit their wages if Ning left the night shift by the furnace vents. “Could the inhalation treatment begin before the transfer is approved?”
“Yes,” the physician said. “It may ease your breathing, but the exposure would continue to aggravate it. The move matters as much as the medicine.”
“What if the steward refuses the station change?” Ning asked. “Would I still start the inhalation treatment?”
“You can start it, but we would watch your symptoms closely. If the work exposure remains high, I may recommend a different plan at follow-up. I can’t promise the inhalation herbs will overcome the vents.” Physician He wrote that answer on the slate instead of leaving it as a verbal assurance. “If your breathing worsens, come back sooner.”
Ning read the note and asked him to define what counted as worse. He named the signs that required an earlier visit, including breathlessness while resting, a fever, or a cough that changed suddenly. Ning wrote each one beside the appointment date.
Yan checked the monthly sum again. “The kit deposit and weekly herbs fit if we keep the same workdays and she gets the east station. If not, we may need to delay the second follow-up until the next pay cycle.”
“We’ll decide after the steward answers,” Ning said. “I can start the first week without committing to the whole package.”
The physician nodded. “That is correct. The plan can be reviewed as your symptoms and work conditions change.”
Ning asked how soon she would know whether the treatment was helping. Physician He described the signs he would track: how often she needed to stop on the stairs, whether the cough woke her at night, and how long the breathlessness lasted after a shift. Ning wrote these down herself.
The infirmary clerk came in with the standard package order. “The qi-strengthening supplement is included,” she said. “It is usually dispensed with the lung-clearing course.”
Ning crossed it off. “I am not ready for that. I want the inhalation plan first.”
“It’s part of the package.”
“Then remove the package and list the items I’ve agreed to.”
The clerk started to reply, but Yan examined the bill. “This supplement is still included after the patient refused it.”
“The standard order is preprinted,” the clerk said.
“Then it needs to be changed.” Yan turned the slate toward Physician He. “The patient asked for the inhalation treatment and follow-ups. The bill still charges a supplement she did not request.”
The physician reviewed the line and drew a mark through it. “Remove it. We’ll bill only the treatments she chooses.”
The clerk amended the order and recalculated the deposit. Ning watched the new total and checked the sum. The number fit their monthly budget if she could trade away the high-vent shifts. She asked the physician to write the station restriction clearly enough that the steward would not treat it as a preference.
Physician He wrote: “Refinery vent exposure aggravates breathing symptoms. Lower-exposure station recommended during treatment.” He signed it and gave Ning the original. Yan received a copied slate total and kept it dry beneath the medicine jar’s cloth wrap.
“Can I start today?” Ning asked.
“Yes. We’ll show you how to use the inhalation kit before you leave. Come back in a week for the first follow-up.”
The clerk brought a small kit and demonstrated how to measure the herbs and sit over the covered bowl. Ning asked her to repeat the amount. She watched the second demonstration and corrected the clerk when the scoop line was not level.
“Show me how long to keep the bowl covered,” Ning said. “And how much water goes in before the herbs.”
The clerk demonstrated both steps again. Ning copied the sequence into her treatment notes, then read it back to confirm she had not missed a measure. The inhalation treatment would take time each evening, but she could prepare it at home after work without paying for a separate clinic session.
“Now I can do that at home,” Ning said. “I’ll begin tonight after the shift.”
Yan asked whether the next appointment fee could be combined with the medicine deposit. The clerk checked the ledger. She could not reduce it, but she wrote the two dates on separate lines so they would not accidentally charge both on the same visit.
Ning folded the bill and tucked it into her pouch. “The lower cost helps. I still need the steward’s approval.”
“I’ll go with you,” Yan said.
“You can carry the kit. I’ll make the request.”
They walked back slowly, stopping when Ning needed a breath. Yan did not ask whether she felt better already. She had not begun the treatment. At the bottom of the stairs, another worker recognized the inhalation kit and asked where she found it.
“The infirmary window,” Ning said. “Ask Physician He which plan fits your symptoms. There are options beyond the standard package.”
The worker glanced at the cost slate in Yan’s hand. “I didn’t know there was a cheaper treatment.”
“Ask for the price of each item separately,” Ning said. “Don’t assume you have to take the whole package.”
The worker nodded and continued toward the clinic. Ning turned to Yan. “It’s better to tell her where to ask than tell her the treatment will work for her.”
“Yes.” He folded the slate copy and returned it to his pocket. “The physician has to assess her.”
At the quarters, Ning laid the original plan beside the shift map. She marked the lower-exposure station and three nights she hoped to switch. The treatment was affordable if the supervisor approved the transfer. She still had to ask for it.
Yan put the medicine jar on the shelf and the bill in the wooden box with her other care records. “We have a price and a next step.”
“And a follow-up date.” Ning touched the line on the paper. “I feel no better yet. I do feel better informed.”
She measured the first dose for the evening and set it beside the clean bowl. The decision and the plan were hers; Yan would carry the kit and the paperwork. Together they had a treatment they could pay for and a request to take to the work steward.