Chapter 189: Ambitions in the Clinic

Director Liu mentioned you more than once while chatting with me. He had promised to take you on as his apprentice and personally train you, but fate had it that you were chosen by the Emergency Department during the selection of general trainee doctors among various departments. You know well how fierce the competition among departments is, with interests all tangled up. Old Liu is merely a deputy chief physician—stuck in the middle—and he just doesn’t have the power to pull you away from the Emergency Department.

Dr. Jia and Mr. Liu seem to have a very good personal relationship.

Otherwise, they wouldn’t be discussing these topics.

Mr. Liu’s standing in General Surgery isn’t too bad, but in the whole of Tuyu Hospital, he hardly makes the grade.

Nowadays, doctors without any academic breakthroughs rarely attain high status—even if their clinical skills are top-notch.

A doctor’s status is determined by three key factors. First, their surgical or treatment ability—being adept at curing illnesses and overcoming challenging cases in a specific field.

These doctors are often renowned specialists or experts in their niche.

Their influence is vast, drawing in countless patients to the hospital.

Such doctors serve as the poster figures for a hospital, holding an almost transcendent status.

Even if their academic record isn’t impressive, it doesn’t affect their standing within the hospital and the industry.

The second factor is remarkable academic achievement.

Doctors who have published numerous papers in important and core journals—at least one of which created a major stir in the field or even led an industry trend—or those with outstanding research accomplishments.

Such doctors typically hold senior teaching positions in medical schools, usually starting at the level of a full professor.

For most, reaching the level of full professor is common.

Those rare few who make it to professorship level are often at the level of academicians.

They not only wield immense influence in the hospital but also in the academic world and society at large.

That’s why every doctor, regardless of their innate talent, spends a great deal of time studying academically.

Since ancient times, the rule has been: ‘All are inferior except the man of letters.’

The medical profession is no exception.

The third factor is holding a high administrative position or having influential patrons.

There’s no need to elaborate on that.

No matter how talented a doctor is, when pitted against such figures, they’re just a junior.

Of course, mutual respect and harmonious relations generally prevail.

Mr. Liu’s academic achievements are questionable at best; his surgical skills are only average, and though his clinical experience is rich, it’s barely an edge. After all, who in a deputy chief physician role isn’t experienced?

So, Mr. Liu’s status within the hospital is rather low.

He can’t possibly be compared with heavyweights like Wu Baihe, Yin Hua, or Hu Kan.

Given his standing, trying to transfer a general trainee handpicked by the Emergency Department is truly over his head.

Back in the Operating Room, Mr. Liu casually mentioned that he would personally train Zhou Can.

Even Zhou Can didn’t dare to take it too seriously.

Unexpectedly, the speaker always remembered that promise.

“Old Liu asked me to train you—it’s his way of fulfilling the promise he made back then. I hope you understand.”

Dr. Jia added as he spoke.

“I understand! Thank you, Mr. Liu, for always remembering someone like me. I’m grateful that you’re willing to train me personally.”

Zhou Can expressed his gratitude earnestly.

“From today on, whether I’m on consultation, performing surgery, or doing rounds, you can follow me. As long as you’re capable, jump in anytime and ask if you’re uncertain about anything.”

Dr. Jia’s message was clear—he would support Zhou Can wholeheartedly.

Moreover, he’d give him the utmost freedom to develop.

This kind of treatment is a dream come true for any general trainee.

For a trainee, being recognized by a chief physician is already a stroke of luck, the kind that makes your ancestors proud. To receive full mentorship from one is as rare as winning the lottery.

“Dong dong dong!”

At that moment, a strikingly young and attractive female doctor knocked at the door.

“Good morning, Dr. Jia! Are you available to do rounds now?” she asked with a smile.

“I’m on my way! Qiu Hong, I’ve just taken on a new student—Zhou Can, a trainee who recently rotated to Gastrointestinal Surgery. Make sure to help him out whenever he’s stumped.”

Dr. Jia was clearly well acquainted with the woman.

After the introduction, he looked toward Zhou Can.

“Her name is Qiu Hong. She’s studied under me for nearly five years. In fields like gastritis and ulcerative colitis in Gastrointestinal Surgery, she’s already made a mark. Her expertise even extends to the diagnosis of malignant conditions and surgical planning for digestive diseases.”

Dr. Jia held her in high regard.

“Sister Qiu, I look forward to working with you.”

Zhou Can was never one to miss an opportunity to flatter.

A simple ‘Sister Qiu’ on his part instantly brought a joyful smile to the female doctor’s face.

“Hehe, you’re not shy at all. Dr. Jia seldom takes on trainees—you must be the first one he’s mentored since his reinstatement. I’ve heard your name, said to be on par with overseas returnee Dr. Du Leng. I’m eager to see your true potential!”

She winked and eyed Zhou Can with a curious, probing look.

Unfortunately, her high hopes quickly faded.

Though Zhou Can looked somewhat handsome and charming, he showed no signs of a master at work.

His attire under the white coat was surprisingly casual.

He sported loose athletic pants and casual shoes. Compared to the immaculately dressed Du Leng, the difference was stark.

Du Leng always dressed formally—suits, dress shoes, shirts, and ties were his norm. His hair was meticulously styled, a picture of a true professional.

“Sister Qiu, please don’t hold your expectations too high. I’m just an ordinary trainee. You can think of me that way.”

Zhou Can said modestly with a smile.

“You may say you’re ordinary, but your performance is anything but. Young male doctors like you are usually very proud and sensitive about their reputation—you, however, choose humility. Under Dr. Jia’s supervision, hiding your talents won’t fly. You must showcase your real skills so he can point out any hidden flaws.”

Qiu Hong wasn’t having any of it.

She was not easily fooled.

“Zhou Can, you don’t need to hide your abilities. Whether during rounds or consultations, as long as you avoid conflicts with patients, feel free to share your insights,”

Dr. Jia also made it clear there was no need for him to be overly modest.

“Understood!”

Zhou Can was shrewd enough to know when to shine and when to hold back. He had never been ambiguous about it.

As a newcomer to Gastrointestinal Surgery, he would seize every chance to prove himself.

“Let’s go check on the ward!”

Dr. Jia rose first, limping slightly as he headed out.

Qiu Hong naturally stepped forward to support him.

Judging by his age, Dr. Jia must be over sixty. Yet he still needed help walking—a fact that surprised Zhou Can.

Even those who do light physical work can hardly hide their age.

They say a man’s prime truly shines at forty-one.

Just around the corner, in the corridor, a dozen doctors and nurses were already waiting.

Among them were several middle-aged doctors in their fifties and above.

Clearly, Dr. Jia is quite popular in Gastrointestinal Surgery.

Zhou Can wasn’t particularly fond of this style of rounds. Being low in status, following the chief physician felt more like a formality.

Once he entered the ward, he realized that Dr. Jia’s rounds were direct and to the point.

He didn’t bother with ordinary beds—only key ones were checked.

Dr. Jia strode straight to Bed No. 3 and stopped.

Lying on the bed was a withered old man with a sallow complexion, pale lips devoid of color, and sunken eyes.

“Patient in Bed 3, Male, 71 years old. He has a 17-year history of recurrent abdominal pain. About three months ago, his condition worsened, and five days ago, the pain was so severe that he fainted several times. Ultimately, after four days of black stools and unbearable pain, he came to our hospital.”

After the attending physician finished outlining the patient’s history, Zhou Can’s interest was piqued.

Diagnosing various cases was his favorite part.

Tracing pathology was one of his strongest suits.

A nearly twenty-year history of abdominal pain indicated a chronic illness.

Such diseases are generally not fatal.

Many manage their symptoms with medication and coexist with their illness.

In fact, over 90% of people over thirty in our country suffer from some chronic condition. They often live with these maladies without drastic consequences, such as severe pain or life-threatening issues, and many never seek treatment.

Take a simple fungal skin infection, for instance—it’s one of the most common ailments among the elderly.

Conditions like athlete’s foot, ringworm, or external itching are typical.

Similarly, chronic gastritis, enteritis, diabetes, hypertension, and asthma are all quite common.

Even tumors and polyps fall under the umbrella of chronic diseases.

This patient’s abdominal pain, combined with recent black stools, strongly suggests gastrointestinal bleeding.

The source of the bleed is likely in the stomach or intestines.

“Six days ago, without any obvious trigger, the patient experienced abdominal pain along with various discomforts, nausea, and vomited twice. There was no coffee-ground vomit, no significant bloating, acid reflux, or heartburn. Later, he fainted and, after falling, lost control of his bowels, producing about two hundred grams of black stool. There were no convulsions or foaming at the mouth, and he soon regained consciousness…”

This case was shrouded in mystery and challenge.

No wonder Dr. Jia focused on this patient right from the start.

“Subsequently, the patient had another episode of black stools, tested positive for occult blood in the stool, and experienced vomiting. His urine remained clear. He was admitted with a diagnosis of duodenal ulcer and hepatosplenomegaly.”

Based on the symptoms, the patient indeed seemed to have a duodenal ulcer.

The presence of hepatosplenomegaly also factored into the diagnosis.

“The patient used to take Pinamytaline and Weishuping on an as-needed basis when experiencing abdominal pain, and each time his symptoms were effectively alleviated.”

This is typical behavior for chronic disease patients.

They’d rather manage with medication than opt for hospitalization.

It’s just about grabbing some drugs to get by.

“Eleven years ago, the patient was treated at a local hospital and was diagnosed with a duodenal bulb ulcer combined with superficial antral gastritis. He was treated and discharged.”

“Currently, the patient’s temperature is 36.8°C, pulse 76 beats per minute, and blood pressure 120/80 mmHg…”

The attending physician went through the patient’s history, past treatments, and basic condition.

Zhou Can, standing at the foot of the bed with several interns and trainees watching from a distance, really wanted to see the patient’s test reports and form a comprehensive diagnosis.

For now, he had to wait for Dr. Jia’s insights.

Dr. Jia eventually diagnosed the patient with a duodenal ulcer and scheduled surgery.

For many gastrointestinal bleeding conditions, surgery remains the only cure.

“Bed 13 patient, Male, 45 years old. He complains of upper abdominal discomfort, nausea, and a sense of fullness. Two hours ago, he suddenly vomited a large amount of fresh blood along with food residue…”

This patient was another high-risk case.

Almost all admissions in the ward involved severe and critical conditions.

At first glance, Zhou Can noticed the man’s pale, sallow, and anemic appearance.

It was also highly suggestive of liver disease.

Especially since the patient’s palms showed clear signs of liver palms.

This admission appeared to be an acute upper gastrointestinal bleeding case.

His current low blood pressure was likely linked to the bleeding.

Surgery needed to be arranged as soon as possible.

After checking on the two patients, Zhou Can got a rough idea of the operations in Gastrointestinal Surgery.

The surgical volume here was huge, and if Dr. Jia truly delegated authority over the next two months, he would certainly rack up plenty of surgical experience.

He might not lead surgeries on his own, but he could actively participate in crucial parts, learning quickly under Dr. Jia’s guidance.

…

After the rounds, Dr. Jia provided instructive comments on the key patients.

He offered guidance on medication, emergency treatment, and then reviewed the surgical schedules for these patients.

For critical emergency cases facing life-threatening conditions, surgery was prioritized.

Just when it seemed Dr. Jia would immediately take them into the Operating Room, he instead led Zhou Can and Qiu Hong to the outpatient department for consultations.

Sitting in on consultations with a chief physician was something Zhou Can had longed for but never thought possible.

Before, because he hadn’t obtained his dual credentials, senior doctors wouldn’t allow someone like him to join consultations.

Only by piteously begging might a junior get to tag along once or twice.

Now it was different—in a private conversation, Dr. Jia had assured him that he could join him for consultations every day and even participate in surgeries.

It seemed Zhou Can’s experience in pathology diagnosis was finally about to get a substantial boost.

His current diagnostic level was at Level 4, comparable to a junior attending physician.

This level could never compare with that of a chief physician.

Yet it was far superior to that of a typical resident.

The three of them entered the outpatient department—a special consultation room reserved for top experts, Room 1.

Well, it appeared that Dr. Jia’s standing in Gastrointestinal Surgery was far higher than Zhou Can had imagined!

Listening to Dr. Jia diagnose those patients and propose treatment plans during rounds had already underscored his capabilities.

Unlike other doctors who cautiously proposed treatment plans, Dr. Jia was remarkably assertive when addressing patients’ queries.

“We can cure your condition; the recurrence rate will not exceed 1%.”

“Your illness is treatable—don’t worry. I’ve performed countless treatments without a single failure.”

Just listen to the confidence in Dr. Jia’s tone.

Patients, hearing him, felt as though they’d been given a dose of reassurance.

Who would dare speak so assuredly to patients and their families without genuine skill?

“Zhou Can, the outpatient department sees a huge volume of patients. Each one comes with unique concerns and conditions. Listen carefully and think things through. If you have any questions, ask me after the patient has left.”

Dr. Jia was wary of his youthful inexperience and the possibility of untimely questions during treatment.

“Understood!”

Zhou Can’s mind wandered slightly, still deeply impressed by the case of the patient in Bed 3.

Even without reviewing the detailed test reports, his recent intensive study in various medical fundamentals—including immunology and gastroenterology—had prepared him well.

Dr. Jia’s diagnosis of a duodenal ulcer lined up with the attending doctor’s assessment.

However, Zhou Can couldn’t shake the suspicion that the patient’s condition was more complex than it appeared.

This was partly due to his three-month stint in the Critical Care Department.

There, he encountered numerous terminal cancer patients daily.

The overall picture of the patient’s condition made him think of cancer rather than a simple ulcer.