Chapter 159: The Heart Behind the Diagnosis

Sometimes, we shouldn’t place doctors or experts on too high a pedestal.

Sure, they know more than the average person and stand out in their specialties. There are diseases they can practically diagnose just by hearing a few symptoms.

Some just need to feel a lump to tell if it’s malignant or not.

But when things get complicated, even experts can lose their confident certainty.

They’re only human. Like any regular doctor, they need to consider a patient’s symptoms, physical exams, reports, medical history, age, overall condition—the whole picture.

Wu Baihe’s skills are top-notch. In the field of neurosurgery in the province, he’s second to none.

But the patient’s condition right now is unbelievably complex. After ruling out a pulmonary embolism, Wu Baihe didn’t dare make any assumptions without seeing the patient in person.

Zhou Can might just be a trainee, but being able to rule out a pulmonary embolism before the angiogram means he’s spotted something big.

His line of thinking is sharper than everyone else’s.

Letting Dr. Kuang listen to Zhou Can right now is honestly the smartest move.

“Shenfeng, are you listening?” Wu Baihe finally broke the silence, speaking up when Dr. Kuang didn’t answer right away.

“I can hear you, I can hear you! But do you really think it’s safe to let a trainee call the shots here?”

Dr. Kuang just couldn’t understand why Wu Baihe would make that decision.

The patient’s life is hanging by a thread. There are so many attending doctors, associate chiefs, department heads—and even a returnee PhD like Du Leng. Yet Wu Baihe wants him to follow Zhou Can’s opinion.

It just didn’t make sense.

“Don’t underestimate anyone. He’s not just any trainee. Eight months ago, an emergency case involving a pregnant woman in shock had nearly the entire Emergency Department mobilized, with top doctors from Internal Medicine, Surgery, and Obstetrics all called for a consult. Director Xie and I went, Internal Medicine’s Director Tan, Director Yin, even Director Zhang from Obstetrics led her own team there.”

“All those high-ranking doctors couldn’t find the cause, but Zhou Can managed to diagnose it. That day left a mark on me. Even after eight months I’m still amazed thinking about it. If you trust me, don’t hesitate—ask him for advice now.”

Wu Baihe never brings this up with anyone else.

After all, so many department heads failing where a trainee succeeded is nothing to brag about.

“He… is really that impressive?”

Dr. Kuang shot a cautious glance at Zhou Can.

“Didn’t you already see what he could do?”

With that, Wu Baihe hung up.

Dr. Kuang’s face went through a series of changes. Asking a trainee for advice just didn’t sit well with his pride.

But Zhou Can had called it before the CT angiogram—no pulmonary embolism—and he’d turned out to be right. That made Dr. Kuang look at him in a new light.

He dropped his initial dismissiveness.

On one hand, a patient could die any minute. On the other, his pride was on the line.

He clenched his jaw, hesitated, then steeled himself and stood in front of Zhou Can.

In the end, he took a deep breath and stepped over his pride.

“Dr. Zhou, I was too stubborn before and ignored your diagnosis. I owe you an apology.” He knew perfectly well that only by apologizing first could he get Zhou Can’s full help in saving this patient.

“That’s too much, Director Kuang. I’m just a trainee. It’s perfectly normal for my diagnoses not to be taken seriously. I didn’t take it personally at all.”

Zhou Can genuinely wasn’t trying to embarrass Dr. Kuang.

If his opinion wasn’t accepted, it didn’t bother him.

If something happened to the patient, it was on Dr. Kuang, not him.

“Uh… well… The tests now show it isn’t a pulmonary embolism—just like you said. Can you share your conclusion? Without knowing the cause, we can’t treat them. The patient’s on the brink, it’s really urgent.”

As Dr. Kuang spoke, he wished he could just stick his head in the sand.

It was humiliating.

His status was almost like being the star pupil in Director Wu’s group.

Now he had to bow his proud head to a trainee from another team. Where did that leave him as an associate chief physician?

Who holds the highest position in a hospital?

It isn’t the director. Not the patient. Not their family, or the doctors.

It’s the sanctity of life.

Whoever can save a patient’s life, whoever restores their health—that’s the real king.

Watching Kuang stammer and panic, Zhou Can couldn’t help feeling a bit thrilled.

Let him be proud, let him look down on others.

In the end, he had to come running for help.

“Let me walk you through my reasoning. The patient’s been in a long-term coma, bedridden for a while, even had a tracheotomy. Of course, they’re prone to lung infections and atelectasis. With shortness of breath and rapid breathing, any experienced doctor would suspect the lungs. But based on some subtle symptoms and the patient’s family situation, I ruled out a pulmonary embolism right away.”

“Because, in bedridden patients with pulmonary embolisms, you usually see symptoms of leg vein thrombosis. But this patient’s legs look totally normal.”

With that, the other doctors lit up with understanding.

“Exactly! The patient’s legs never looked swollen or off-color. How could it have been a pulmonary embolism? I had my doubts, too.”

“Dr. Zhou really knows his stuff!”

“Quiet, everyone. Let Dr. Zhou finish explaining his thinking.”

Dr. Kuang shot an annoyed glare at his own colleagues.

People love to talk with hindsight, but when it comes to real emergencies, they’re hopeless.

They’re all talkers.

But when trouble hits, no one’s reliable.

“I mentioned before: for terminal patients who’ve been bedridden a long time, the family’s hope might not be a miracle, but a medical accident. I know it sounds grim, but it does happen. I think this critically ill patient may have long been waiting for something to happen. So, Director Kuang, don’t be too optimistic.”

Hearing Zhou Can repeat this now hit everyone differently.

Before the tests, they’d thought he was talking nonsense.

Now, they realized he meant every word—he had a reason.

A deep worry showed in Director Kuang’s expression.

It wasn’t that he was scared easily, but Zhou Can shattered his wishful thinking with facts.

“Looking at the choices made in this patient’s ICU treatment, it’s all bare bones—saving wherever possible.”

Zhou Can pointed at the fee statement: nothing expensive, only basic life-saving measures.

Only the most essential interventions were given.

“That means the family is likely in heavy debt, deeply short on cash. Plus, the patient, even though comatose, has a faint smile on his face. In someone suffering so much, a genuine smile means he’s finally getting that ‘accident’ he wished for and feels relieved—like he’s been set free.”

Zhou Can’s analysis sent shivers down Kuang’s spine.

Who would’ve thought a dying patient could plot things this far.

This is a lesson none of the doctors here will ever forget.

In the big picture, it’s actually a good thing.

It’ll make them all more cautious at work from now on.

It’s an indirect way of holding everyone to higher standards.

“If I pull this patient back from the brink, that ruins his plan. Truth is, even if he survives this, he doesn’t have much longer to live. Trading his remaining life for compensation to help his family—that’s a deal he feels is worth it.”

Zhou Can didn’t give his conclusion right away, seriously weighing whether saving the patient was truly the right call.

The patient probably leaves behind a family buried in debt.

Zhou Can had no doubt the patient wants to use the last of his life to secure some compensation.

Cutting off someone’s financial hope is as cruel as taking their family.

“Dr. Zhou, you can’t just think of the patient! What about me? If there’s a medical accident, my future’s toast! Sure, the hospital pays part of the settlement, but I’ll be left with plenty of the bill myself. I give my all to help patients, only to end up being taken advantage of. I’m worse off than the patient!”

Dr. Kuang blurted out, desperate.

If Zhou Can refused to help, there was nobody else.

What could Du Leng, who only talks big, or Director Wen, whose diagnostic skills were average, do?

They couldn’t help.

Only Zhou Can had a shot at changing things.

“Dr. Zhou, I agree—we can’t just pick the patient’s side. The weak aren’t always right. Let’s get him stable first, then figure out how to help with donations. That’ll ease the burden on the family, too.”

Director Wen’s suggestion was the best of both worlds.

No doubt about it—Wen’s thinking was on a higher level.

“Alright, I’ll go with your idea.”

Zhou Can respected Director Wen and agreed immediately.

“But before we start, we’ll need your help with arranging the donations for the family after the rescue, Director Kuang.”

He looked at Dr. Kuang.

People are good by nature.

When we see those struggling, it’s hard not to feel their pain and want to help.

“No problem. That’s easy—I’ve got a friend from high school who works as a journalist. I’ll ask him to write a piece about it to raise some donations for the patient.”

Dr. Kuang agreed without hesitation.

He didn’t dare think long—the patient was still waiting.

Every moment wasted was putting them more at risk.

“Shortness of breath, rapid breathing, plus the lung infection—you’d naturally focus on the lungs, but the heart was ignored. I strongly suspect heart failure, and most likely right-sided failure.”

Zhou Can finally revealed the real cause.

Really, if you weren’t blinded by the lungs, you’d pick up right away it was heart failure.

“Right! How did we all miss the heart? Heart failure can definitely cause those symptoms.” Director Wen clapped in agreement after hearing Zhou Can’s conclusion.

Diagnosis can be like solving a riddle.

Once you know the answer, it feels obvious.

But when you’re guessing, it’s just maddening.

“To confirm right-sided heart failure is actually simple. Do an echocardiogram, check the pulmonary artery pressure. Just a heads up, though—the patient probably has cor pulmonale. From what I know, the outlook for that isn’t good.”

Zhou Can said to Dr. Kuang.

Heart failure is one of those extremely tough conditions to fix.

Back in the old days, doctors called it incurable—and heart failure was one of those conditions.

“Let’s stop talking and get him in for an echo ASAP. Cor pulmonale may be hard to treat, but keeping the patient alive isn’t out of reach.” Dr. Kuang’s brow eased once he knew the real cause.

Now all that was left was to wait for the results.

He had a strong hunch Zhou Can would be right again.

Sure enough, the results came fast. The patient’s pulmonary artery pressure was over 50 mm.

Thankfully, the diagnosis came in time. It hadn’t reached the critical 70 mm mark yet.

With the right medication in time, the patient could still be pulled back from the brink.

“Dr. Zhou showed me what real skill is and taught me a lesson. From now on, I’ll keep my pride in check and always listen carefully to every diagnosis.”

With that, Dr. Kuang basically admitted his mistake to everyone.

He meant it—he would change his ways.

“And I’ll keep my promise to help raise donations for the patient, too. Dr. Zhou, thank you. Director Wen, Dr. Zou, Dr. Tang, thank you for lending a hand.”

Today really gave Dr. Kuang a scare.

But now the crisis had passed.

He finally allowed himself to relax.

“We’re colleagues—no need to be so polite. Get those meds prescribed! And next time you’re on ICU duty, don’t get careless again.”

Director Wen waved him off, urging him to treat the patient quickly.

Delay too long and once that pulmonary artery pressure tops 70 mm, things become critical.

As Du Leng left with Dr. Kuang, he shot a deep look at Zhou Can.

Their eyes met—Zhou Can looked completely calm, but Du Leng’s gaze brimmed with hostility.

Du Leng lost badly in today’s rescue attempt.

Zhou Can showed him exactly what it meant to have false credentials.

What good is a fancy degree if you can’t treat patients? Is your life just papers and research?

But even writing those papers needs hard-won experience to back them up.

Research without practice is just a castle in the air.

“This contest between us is just beginning, so don’t get cocky.”

Du Leng shot cold words at Zhou Can.

“Did I gloat? Maybe you should stop judging everyone by your own standards, Dr. Du. That attitude won’t help you.”

Zhou Can shrugged with a smirk that was part satisfaction, part taunt.

“You… Hmph! I’ll show you that nothing can replace education. Knowledge is everything.”

Du Leng usually puts on a sanctimonious show in front of others.

But now anger flushed his face, revealing who he really was.

Losing to Zhou Can again and again was clearly hard to swallow.