Chapter 153: Calculated Diagnosis and Rising Authority

Dr. Ou, just in time. This patient has a fever of 39.2°C. After reviewing his reports and test results, I believe we can’t simply lower his temperature!

Zhou Can got straight to the point.

His approach was remarkably brilliant; he didn’t use his influence to hound Dai Wei and Chen Hao.

I’m sure Dr. Ou’s earlier attitude already made them think twice.

But he couldn’t help feeling puzzled – did they not know at all that Director Wen favored him, or did they only catch wind of it and thus not take him seriously?

Zhou Can’s standing in the General Surgery Department meant that even ordinary residents lost all confidence in themselves around him.

Even Cheng Gang, who had once treated him with disdain, now bowed his head.

They just couldn’t face him, so they refrained from any attempt at ingratiation.

Why is Dai Wei so clueless?

“Dr. Dai, were you really angry about this earlier?” After Zhou Can’s explanation, Dr. Ou directed his gaze toward Dai Wei.

“Uh… I did lose my temper a bit. I was mainly worried that Dr. Zhou’s words might spark unnecessary disputes with patients,” replied Dai Wei, adjusting his stance to the situation.

Once he noticed Dr. Ou’s warm regard for Zhou Can, he immediately cooled off.

“Just because he’s a trainee, do you think his opinions amount to nothing? Let me tell you, Dr. Zhou has achieved significant merit during several director-level consultations. And just today, while assisting Director Wen in a Level Four surgery, he once again proved his worth. Never underestimate a junior doctor again.”

It was clear that Dr. Ou and Dai Wei enjoyed a decent rapport.

Otherwise, he wouldn’t have said such things.

By revealing so many of Zhou Can’s details in public, it was obvious Dr. Ou had been inquiring about his accomplishments in the Emergency Department.

Tuyu Hospital may seem neither huge nor small, but its internal relationships are incredibly intricate.

Perhaps a certain doctor or nurse from the Emergency Department happened to be on friendly terms with Dr. Ou—even an old classmate.

Yesterday, Dr. Ou personally witnessed the entire process of Zhou Can earning Director Wen’s favor and, out of curiosity (or perhaps personal interest), he asked around.

What a surprise!

Who would have thought that this trainee was absolutely phenomenal!

“Director-level consultations, a Level Four general surgery operation with multiple key contributions… oh my goodness! It’s like a flood overwhelming a dragon king’s temple. I had mistakenly thought of Dr. Zhou as one of those flashy, overambitious trainees. That was my error – I promise to change my ways from now on.”

Hearing about Zhou Can’s brilliant achievements, Dai Wei recoiled in fear and quickly moved to remedy the situation.

Apologizing immediately was indeed the wisest course.

“I’m not nearly as impressive as Dr. Ou claims; perhaps I’m just a bit luckier. As for this patient, I strongly recommend we check his blood pressure. If he shows signs of hypotension, we must be on high alert.”

With that understated remark, Zhou Can had achieved his purpose.

Then he moved on to more urgent matters.

This maneuver served to ease Dai Wei’s embarrassment to the fullest.

As for the sycophantic trainee Chen Hao, Zhou Can had never considered him more than a nonentity.

He was as insignificant as the air itself.

“Chen, measure the patient’s blood pressure immediately – don’t just stand there,” ordered Dai Wei, whose knack for survival at work was impressive indeed.

Knowing Zhou Can’s prowess, not only did everyone look up to him in awe,

but his close friend Jin Mingxi also gained a newfound level of respect.

Meanwhile, the status of the flatterer Chen Hao plummeted dramatically.

“Isn’t Dr. Jin handling this patient?”

Chen Hao muttered under his breath.

He clearly wasn’t used to such an abrupt shift in his treatment.

“Hurry up!”

Dai Wei’s tone had turned icy as his gaze grew stern.

Only then did Chen Hao realize the winds had changed; he obediently fetched a blood pressure cuff and began the measurement.

Dr. Ou and the others waited close by, eyes fixed on the results.

“Is this cuff broken? Why is the systolic only 100 mmHg?” Chen Hao murmured after his initial reading.

“Chen, stop dawdling! Where are the results? Both Dr. Ou and Dr. Zhou are waiting!”

Dai Wei promptly placed Dr. Zhou on the same level as Dr. Ou – a true act of self-preservation!

Yet, Zhou Can seemed completely unbothered.

Nearby, Jin Mingxi couldn’t hide his admiration.

Jin Mingxi had nearly been promoted to associate chief at the County People’s Hospital, but having come to Tuyu Hospital as a trainee, his prospects appeared diminished.

Meanwhile, Zhou Can – also a trainee – had an implicit status already on par with an attending physician.

Amid his envy, Jin Mingxi felt a surge of quiet joy.

Following the earlier commotion, Dr. Dai now fully recognized Zhou Can’s capabilities and treated him with utmost reverence.

With Zhou Can’s backing, Jin Mingxi believed his future would look much brighter.

When Dai Wei pressed his advantage, he obviously wouldn’t dare be as unbridled as before.

Sweating profusely, Chen Hao dashed to the nurses’ station to borrow another blood pressure cuff.

He measured once again.

“What’s going on? The systolic is now only 98 mmHg.”

Chen Hao could hardly believe the result.

“Idiot – you can’t even measure blood pressure properly. How can the patient’s systolic be so low? Let me do it.”

Dai Wei personally took charge.

Yet the result remained unchanged at a systolic of 98 mmHg.

At that moment, both Dr. Ou and Dai Wei realized how grave the situation was.

Experienced doctors typically see a systolic below 90 mmHg as a threshold for shock.

This patient’s blood pressure was dangerously close to that point, frightening them both.

“Thank goodness Dr. Zhou suggested checking the blood pressure – we nearly missed a disaster.”

Dai Wei dabbed the sweat from his brow, shaken by the close call.

He now had his first personal encounter with Zhou Can’s expertise.

No wonder he earned Director Wen’s favor even as a trainee – his skills were truly impressive.

Meanwhile, the patient began to mutter incessantly.

His consciousness was clearly in disarray.

Even his family’s calls had little effect.

The patient’s condition was deteriorating rapidly.

Or perhaps his abnormal state had gone unnoticed until now.

After all, babbling under a high fever is not uncommon.

“Dr. Zhou, the patient’s condition is dire. Please give us your full diagnosis! While I may be an attending, pathology has always been my weak point. The fact that, just by reviewing his records and noting his high fever, you could infer his dangerous hypotension means you already have a diagnosis in mind.”

Seeing his patient’s peril, Dr. Ou felt a surge of intense anxiety.

He hoped that even if Zhou Can took his time, the cause might still be uncovered.

But since someone was clearly more adept, there was no point in straining himself.

Besides, every delay only made things riskier.

The patient’s family was beginning to understand that this loquacious young doctor possessed remarkably advanced medical skills.

Their eyes pleaded silently as they looked to Zhou Can.

“Let it be clear – this is only a preliminary diagnosis based on a few clues, and the result might not be definitive. I recommend we immediately draw blood for tests. The patient might be suffering from septic shock.”

Zhou Can modestly hesitated to commit fully to his diagnosis.

In truth, his extensive experience had already ensured the diagnosis.

He was completely certain of his conclusion.

“But the patient isn’t in shock yet, right? Isn’t shock defined only when the systolic drops below 90 mmHg?”

Dr. Dai was utterly baffled.

“How old-fashioned! Who says shock can only be defined by a systolic below 90 mmHg? Your rigid dogmatism is unacceptable. Septic shock cannot be judged solely on blood pressure.”

Dr. Ou treated Dai Wei almost like a student.

Otherwise, he wouldn’t have chided him for such a rigid mindset.

“Dr. Zhou, please explain the criteria for diagnosing septic shock,” Dr. Ou prompted, giving Zhou Can the floor.

Perhaps he also intended to give the others a chance to mend bridges.

“Low blood pressure, high fever, confused consciousness, and a neck that is unnaturally stiff – taken together, these signs virtually confirm septic shock. Of course, we’ll await the blood test results for absolute certainty.”

From the moment he entered the ward, Zhou Can had noticed the patient’s pallid complexion and unusually pale lips.

Even his fingertips had a slight bluish tint.

He also observed that the patient’s neck was abnormally stiff – any movement, whether twisting or bending, appeared off.

Putting all the symptoms together, he boldly deduced that the patient was already in shock.

He administered an indomethacin suppository – a typical case of treating the symptom rather than the cause.

It was a haphazard, superficial fix.

One might even call it completely off-target.

When someone develops a fever, unless it exceeds 39°C, there’s usually no need to rush to lower it.

That fever is the body’s natural immune response, fighting off invading viruses and bacteria.

Most fevers result from inflammation or a common cold.

Some people – particularly children – take a load of antipyretics the moment they develop a fever. The fever subsides, but they miss the chance for their body’s immunity to eradicate the virus.

To put it vividly: when the body starts to fever, it gears up to battle invading viruses.

It burns stored energy, raises body temperature, and begins to destroy the virus.

For those without medical knowledge, taking a heap of fever reducers is like a foolish emperor ordering a retreat just as victory seems near.

The emperor’s command essentially halts the general’s advance even when victory appears imminent.

In the end, he might even order the general’s execution.

Then the viruses rejoice – if they can’t bring down that foolish emperor, who will they fear?

They proceed to invade more organs and tissues.

A simple cold might escalate into a severe one, even proving fatal.

Many claim that drinking plenty of warm water after catching a cold is nonsense.

But can water really cure an illness?

The answer is yes.

Plenty of water keeps the body’s metabolism running efficiently, flushing out viruses and toxins through urine and other means.

This is highly beneficial for recovery.

Speaking of body temperature, there’s something that should alarm all of humanity.

Our average body temperature has been steadily dropping.

Thousands or even tens of thousands of years ago, we couldn’t know our ancestors’ temperatures because of limited technology.

But in the past two hundred years, the average temperature has dropped from 37°C to 36.6°C, with 37°C now a historical norm.

Some might dismiss a 0.4°C drop as trivial.

In fact, for every 1°C drop, immunity declines by over 30%.

Conversely, a 1°C increase boosts immunity by five to six times.

So, in the future, when you have a fever, don’t rush to lower it! As long as it’s below 39°C, just monitor it, stay hydrated, and keep warm.

Help your body fight off the illness and crush the virus.

……

After diagnosing the patient’s illness, Zhou Can decided there was no need for him to linger any longer.

“Dr. Ou, Dr. Dai, I’m off now! Once the patient is confirmed to have septic shock, don’t delay treatment – especially post-surgery, as that can be fatal.”

Before leaving, Zhou Can made sure to remind them carefully.

“Understood! I’ll report this immediately to Director Wu,” said Dr. Ou in a stern tone. “Thank you for helping us avert a hidden disaster today. If you’re free sometime, Dr. Zhou, I’d really appreciate you stopping by the ward daily to lend your expertise.”

Dr. Ou was deeply grateful to him.

But he knew that having Zhou Can in the ward every day was unrealistic.

Even an occasional visit was already a special favor.

“Sure thing! Dr. Jin is my good friend – if time permits after work, I’ll definitely drop by his ward often.”

Before leaving, Zhou Can reiterated his close bond with Jin Mingxi.

Essentially, he was telling Dr. Ou and Dai Wei, ‘Take good care of my good friend.’

“Now that I know Dr. Jin is a friend of Dr. Zhou, I’ll make sure to mentor him closely,” declared Dai Wei on the spot.

“When you work with giants, only fierce talents survive. If Dr. Zhou is this formidable, then Dr. Jin must be just as good. Otherwise, we’d be wasting a talent. If his surgical skills are up to par, you can assist me in surgery someday.”

Dr. Ou, eager to curry favor with Zhou Can, had just done him a massive personal favor.

It was like having a huge windfall drop right at his feet – leaving Jin Mingxi overjoyed.

“Thank you, Dr. Dai! Thank you, Dr. Ou! I’ve managed plenty of surgeries in the Emergency Department, and I look forward to further guidance from you in the future.”

Jin Mingxi truly impressed everyone.

When dealing with a snake, you strike with a stick.

He immediately clung to Dr. Ou’s leg.

“Alright, tomorrow I have two surgeries. Just come along with me in the operating room,” Dr. Ou agreed without hesitation.

After speaking, he turned his gaze to Dai Wei.

“Dr. Dai, assign fewer tasks to Dr. Jin tomorrow – let him join me in the operating room.”

Dr. Ou’s straightforward nature shone through as he addressed Dai Wei directly.

He greeted him openly.

“No problem. Since Chen’s workload is light, I’ll have him handle extra tasks.”

Dai Wei’s remark nearly sent Chen Hao to tears in the restroom.

Who would have thought that the sudden emergence of this uncompromising trainee would upend the established order, turning Dr. Jin – once considered just a minion – into a rising star?

His prior reliance on flattery for advancement had rendered him expendable.

Indeed, true ability reigns supreme.

All those convoluted maneuvers are nothing compared to genuine strength.

“Goodbye!”

With a wave, Zhou Can departed with a satisfied smile.

……

Before 7 PM, Jin Mingxi returned.

As soon as he entered the dorm, his face radiated pure joy.

He immediately placed two steaming chicken legs in front of Zhou Can.

“Zhou Can, you’re a real pal. If it weren’t for your support today, I’d have been completely steamrolled by Dr. Dai and Chen Hao. Forget the formalities – consider these two chicken legs my token of gratitude.”

Jin Mingxi’s face beamed with a smile.

For such a huge favor, two chicken legs were hardly enough. But among close friends, it said more than a thousand words.

It was just a token – that was all.

From now on, whenever Zhou Can needed help, Jin Mingxi would always be ready to lend a hand.

“Ha, with these two chicken legs, I won’t hold back!” Zhou Can washed his hands and eagerly picked up the hot chicken leg to enjoy.

“I was going to treat you to a feast, but you know how it is – a trainee’s salary is peanuts. I scrimp and save daily, and if I can even clear my credit card bill at the end of the month, it’s a win. Asking my wife for money would just be out of the question.”

Jin Mingxi had been a resident in the provincial capital for over six months now.

Back when he first arrived, he was quite generous.

Now, times were tight.

This was why most medical students grumbled about the residency system.

It was essentially exploitation by the hospital for one to three years.

Raising a medical student is an enormous financial and emotional burden on a family.

After graduation, during the one to three-year residency, families often have to make extra sacrifices.

If you had a degree in finance, a three-year stint would likely land you a high salary.

That’s why being a doctor purely for the money is not a wise pursuit.

“No wonder – I’ve noticed you rarely spend time with that classmate Yezi these days. Looks like your wallet’s been emptied. I even worried about your wife the other day!”

Zhou Can and Jin Mingxi were very close, so such teasing was all in good fun.

“Don’t say that! I’m not that kind of person. Besides, Yezi only invites me out not for my money – she’s been financially independent for ages.”

Jin Mingxi’s face flushed as he defended his friend.

Zhou Can just smiled and let it drop.

After all, they were all adults, free to choose their own ways of life.

After finishing his chicken leg, Zhou Can returned to practicing his Rapid Surgical Technique.

Today in the operating room, after experiencing the technique’s prowess firsthand, it was as if he’d been possessed—obsessed with reaching even higher levels.

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