Chapter 201: Breakthrough in Diagnosis: The Hidden Cause Revealed

After this, things became much simpler. They arranged for the patient to undergo 24-hour EEG monitoring and bowel sound localization.

For these tests, the patient needed to stay in the hospital, but it didn’t mean admission as an inpatient.

It was simply a specific diagnostic procedure.

After a full day of monitoring, both the 24-hour EEG data and bowel sound recordings were completed.

Naturally, this wasn’t something Zhou Can needed to handle himself.

Dr. Jia temporarily assigned two interns to monitor the patient’s bowel sounds and pinpoint their locations.

Bowel sound monitoring didn’t need to be around the clock—it was mostly focused right before meals and about half an hour afterwards. Still, the doctors had to draw precise diagrams of where the sounds occurred.

This job called for a solid grasp of specialized knowledge.

At the very least, you had to know clearly which segment of the intestines was making noise.

Having two interns do the job together was just to ensure nothing got missed and the results were as accurate as possible.

In the Gastrointestinal Surgery consultation room, more than ten doctors sat for the joint meeting.

All the chief physicians from GI Surgery were present.

There were five challenging cases and complex surgical plans up for debate—solving these required everyone’s combined brainpower.

The first case brought up for discussion was this pseudo-enteritis patient.

“The patient is seventeen, has had diarrhea for over two years, and his symptoms closely mimic enteritis.”

Dr. Jia first introduced the patient’s case, then projected the test results and other data for the group.

“Looks like textbook enteritis to me!”

A youthful associate chief physician, probably in his forties, gave his verdict after a glance.

“I’m familiar with this case. Just over half a month ago, Gastroenterology asked me to join a consult. We discussed it at length but couldn’t find the real cause. I can basically say for sure it’s not ordinary enteritis. The patient’s also been treated in several major hospitals with no improvement.”

This time, it was Director Xiao from GI Surgery speaking—fifty-six years old and head of the whole department.

In skill and experience, he ranked just behind Dr. Jia.

That associate chief physician who spoke first was immediately proven wrong.

Youth had its drawbacks—speaking up too hastily would often get you slapped down.

“If it isn’t ordinary enteritis, then what is it? Something like Crohn’s disease, maybe—chronic enteritis that’s hard to cure?” The flushed associate chief physician pressed on.

In his early forties, he really was a ‘young man’ among doctors.

Still, you had to admire his drive and willingness to voice his opinion.

During these consultations, everyone spoke their minds freely. There was no need to hold back.

To be fair, his enthusiasm deserved some praise.

“We can rule out Crohn’s, but chronic enteritis is still a possibility.”

Director Xiao replied.

“Dr. Zhou Can from our team believes it’s pseudo-enteritis. He arranged for the patient to have 24-hour EEG and bowel sound monitoring yesterday. Let’s have Dr. Zhou walk everyone through his thought process!”

Dr. Jia didn’t try to hog any credit.

He directly pushed Zhou Can into the spotlight.

The whole room stirred, and all eyes landed on Zhou Can.

Zhou Can stood up to explain his diagnostic approach to the senior doctors.

He’d barely finished when Dr. Jia gestured, “Zhou Can, now that you’ve got your monitoring data, why don’t you tell us your diagnostic conclusion?”

The doctors, after listening to Zhou Can’s analysis, began to think deeply.

For this trainee who’d racked up achievement after achievement, the chief physicians had long stopped seeing him as just a trainee. He was now treated as an equal.

“After comparing the EEG data, I found the patient’s brainwave patterns weren’t far off what I’d expected. Only during sleep did the EEG approach normal, and at those times, the bowel sounds stopped. That tells us the patient’s mind stays highly strained during the day. This further suggests there’s a link between his chronic diarrhea and mental tension.”

“Also, after the patient eats, the bowel sounds suggest food enters the duodenum after being digested in the stomach, but the intestinal motility is much faster than normal. I suspect food is quickly moved along, hits the rectum, and is expelled. This abnormal gut activity is probably due to disturbed nerve signals.”

Speaking confidently, Zhou Can supported every point with firsthand monitoring results.

He pointed straight at the real problem: neurogenic gastrointestinal dysfunction.

“As we all know, gastrointestinal neurosis really just means functional disorders of the gut. Functional dyspepsia is an umbrella term for this syndrome—it’s a malfunction of the autonomic nervous system triggered by higher-level psychological disturbances.”

The key issue is abnormal gut movement or secretion. There are no pathological tissue changes, and it doesn’t include gastrointestinal dysfunction caused by other systemic illnesses.

“If we strip away some of the misleading surface symptoms, this patient’s condition matches neurogenic digestive dysfunction pretty closely.”

After Zhou Can finished, the other doctors again fell deep into thought.

“Your analysis makes sense and has evidence behind it, but it’s still not enough for a definitive diagnosis!” That same unflappable associate chief physician was the first to question him.

“It’s actually not hard to nail this down. Let the patient try a medication to relieve anxiety, then, once the EEG stabilizes, have him eat. If his gut motility goes back to normal levels, that’s your answer.”

Zhou Can had already thought of the next step.

If a problem this small could stump him, then his three months in Critical Care would’ve been for nothing.

Studying the body’s three major systems and doing hands-on practice gave him a deep understanding of each one.

“I say it’s worth a shot.”

Director Xiao’s eyes brightened.

Both Zhou Can’s analysis and his experimental method were refreshingly unconventional.

“Write the prescription right away. Let’s see how the treatment goes.”

Dr. Jia quickly penned a prescription and gave it to Qiu Hong to carry out.

……

As the consultation was wrapping up, Qiu Hong came running back, face lit up with excitement.

She was practically beaming.

“Dr. Jia, after giving the patient the medication and waiting for the EEG to stabilize, we had him eat. Forty minutes later, his gut motility was still normal, and for the first time ever, he didn’t have diarrhea. His family was overjoyed, saying our hospital really does live up to its reputation as the province’s best. They kept praising you and Dr. Zhou for your medical skills—said you’re living legends!”

As she shared the news, Qiu Hong couldn’t hide her pride.

This initial trial pretty much confirmed that the patient’s enteritis was truly linked to psychological stress.

Now, nobody doubted Zhou Can’s diagnosis.

Everyone looked at Zhou Can with admiration or sincere respect.

No one was shocked, though—by now, this wasn’t the first time Zhou Can had pulled off a miracle.

He’d solved a string of baffling and dangerous cases already.

“I barely deserve any credit for this case—it’s mainly Zhou Can’s accomplishment.” Dr. Jia was nothing if not fair and never snatched his team’s achievements. “Zhou Can, we’ve basically confirmed it’s a psychological disorder. What’s your proposed treatment? I’d like to hear something that aims for a cure, not just long-term control with medication.”

Dr. Jia was something like a mentor for him.

When making requests, he spoke in the warm tone of an elder to a promising youth.

Given how much he’d taught and supported Zhou Can, he certainly had the right.

From another angle, it showed how close their relationship had grown.

“To cure him, we have to find the source of his stress. Based on his family’s account, I suspect it’s linked to the high school entrance exams. He first got sick midway through his third year—the most stressful stretch before those exams. Stress triggers for kids this age aren’t hard to figure out. I’d like to speak with him and his family to learn more, then tailor a treatment plan. Is that alright?”

Recently, Zhou Can had been brushing up on the fundamentals of psychology.

This turned out to be the perfect opportunity.

He suspected the cause of the boy’s crippling anxiety might be linked to the high school entrance exams.

Even if it wasn’t, it should still be easy to get to the bottom of.

Possibilities like parents having marriage troubles, the boy getting hurt by a first romance, or a teacher severely criticizing him—all could drive this sort of tension.

As long as his mental knot could be unraveled, the illness would clear up on its own.

“Go on, then! I’m eager to see how this turns out!”

Dr. Jia urged Zhou Can to go and talk things over with the patient and his family.

……

It didn’t take Zhou Can long to spot the smiling family member just outside the EEG monitoring room.

Now that the cause had been found and the medication was working, their happiness was plain to see. The worry lines had mostly vanished, replaced by a genuine smile.

“Dr. Zhou, thank you for saving our son. You’re the benefactor of our whole family!”

As Zhou Can approached, they hurried over, repeating their thanks with deep emotion.

“I just played a supporting role in treating your son—most of the credit belongs to my mentor, Dr. Jia. I’m here now because I want to talk about what triggered his illness. Hopefully, we can help cure him completely, not just control it with meds.”

Zhou Can didn’t worry about the setting and just sat down with the family on a bench outside to chat.

“Did you ever put pressure on your son about the high school entrance exams? Like hoping he’d get into a top school or something?”

“We did! Back then, as the exams got closer, his dad stressed more than once that he wanted him to get into No. 1 High in the county. Since he’s our only child and pretty good at school, we both had high expectations. But could that actually make him sick with diarrhea?”

They weren’t challenging Zhou Can.

Just found it a bit hard to believe.

No wonder they couldn’t grasp it.

Without medical training, who’d think that exam pressure could actually give a kid diarrhea? In their minds, you only got it from bad food or illness.

“I can’t say for sure just yet. Is your son able to talk to you normally?”

Zhou Can had tried questioning the patient in the clinic before, but couldn’t get him to respond.

The boy showed signs of autism.

Back then, they’d figured it was the illness itself that made him withdraw.

Now, Zhou Can realized it might have been triggered by the mental health problem.

“He can! When we’re alone, he answers pretty normally. He’s always been a quiet, introverted kid.”

The boy’s mother replied.

“As long as someone can talk to him, that’s a good sign. Try having a conversation—let him know getting into a prestigious high school isn’t everything. Help him untie his mental knots and walk out of this cage he’s built for himself.”

Next, Zhou Can gave the mother some pointers on how to comfort and guide her son.

They just needed to provide as calm and private a space as possible. That wasn’t hard—just pull the curtain around the hospital bed to create a cocoon.

Following Zhou Can’s advice, the mother went in to have an honest talk with her son.

If that didn’t work, they’d have no choice but to seek specialized psychological counseling.

It was less than half an hour before they heard muffled sobs from inside.

The boy’s father had been anxiously waiting outside. The moment he heard his son crying, he started to rush in to check on him.

Zhou Can quickly held him back.

“It’s a good thing he’s crying. What you should worry about is when he bottles it all up and suffers alone. When you see your son, reassure him he doesn’t need to get into some top school—don’t give him more pressure. What he does need is all the warmth and support you can give.”

For a seventeen-year-old, crying like this meant his emotional dam was breaking—it was the beginning of real relief.

Crying marked the collapse of those internal barriers.

It was a good sign.

Zhou Can was much too busy to stick around.

After a few reminders, he left to take care of other work.

It was just after one in the afternoon. Zhou Can was back in the office, writing up records and checking information.

The boy’s father showed up.

He rushed in and nearly fell to his knees.

Startled, Zhou Can quickly jumped up to steady him. The other doctors watched in shock.

“Dr. Zhou, thank you so much… My son had more than half a bowl of rice and quite a bit of food at lunch—the first time he’s called out to me in over two years. And after eating, no diarrhea! It’s incredible. By saving my son, you’ve saved our whole family. If he’d died, our family would’ve fallen apart.”

The man’s voice trembled and caught several times.

For most families, their children are their hope—their lifeblood.

“That’s fantastic! Nothing makes us doctors happier than seeing a patient on the mend. Your son’s still very thin from long-term malnutrition. Don’t expect to fatten him up with just a meal or two—what he needs is gradual progress. Don’t suddenly give him heavy or rich foods—take it slow, step by step.”

“Along with gradually improving nutrition, try getting him to move around more. Once he can stand, have him walk and get fresh air. When Dr. Jia comes by, I’ll ask if he needs any medication.”

The good news filled Zhou Can with genuine happiness.

He’d finally managed to save another patient who’d been staring death in the face.

[Pathology Diagnosis EXP +1.]

[Congratulations! You’ve successfully diagnosed an ultra-difficult case. Reward: Pathology Diagnosis EXP +100. Life-saving Insight EXP +100.]

Two major rewards landed for Zhou Can at once.

[Congratulations! Your Life-saving Insight skill has advanced to Intermediate. Current EXP: 1/10000. During resuscitation, clarity of thought and diagnostic reasoning are doubled!]

That special skill actually leveled up to Intermediate.

Zhou Can was over the moon.

A skill like this was different from the usual medical knowledge—it worked quietly, almost unseen, like gentle spring rain.

It sharpened his diagnostic ability and helped him stay calm when it mattered, cutting straight through misleading symptoms.

A 100% boost in diagnostic reasoning? That was no small thing.

In his view, that meant his ability to diagnose critical cases had doubled.

But to really know for sure, he’d have to test it out on the next patient.