Chapter 234: Critical Diagnosis: The Perils of Toxic Chicken Soup

“But chicken soup is always boiled, and it stays hot for a long time. There’s no way any bacteria could survive in chicken soup at 100 degrees Celsius.”

Yu Xin shared her opinion.

Salmonella can survive and reproduce inside chickens without causing them much harm.

But once it enters a human body, it can be deadly.

Usually, exposing the bacteria to temperatures over 60 degrees Celsius for fifteen minutes is enough to kill them.

“Under normal circumstances, there shouldn’t be any live Salmonella in boiled chicken soup. But there are always exceptions. If the bacteria are hiding deep inside the chicken and the cook cuts really large chunks, the heat might not reach the center. Plus, afternoon hours in small restaurants—around four or five o’clock—are often their busiest time. That’s when dishes get rushed for the evening rush.”

“Think about it. How long do you think the chicken soup actually simmers in those conditions? If there’s still Salmonella inside the meat, the family would let the chicken soup cool to a palatable temperature before giving it to the patient. Typically, that’s about forty or fifty degrees—not too hot, not too cold. In that window, the bacteria could escape into the soup and survive.”

Zhou Can had more hands-on experience than Yu Xin.

He always saw things from a wider perspective.

Hearing his explanation, Yu Xin started to think he had a point.

“Back then…I really did let the soup cool before giving it to my husband. But I drank some too, and I was fine. Why did only he get sick?” The family’s question was something that came up a lot in daily life.

Sometimes two people eat the same thing, but only one gets sick.

Someone else might get a bad stomach from the very same meal.

“That’s because healthy adults have strong stomach acids that can kill off most bacteria before they do any harm, but this depends on the person. Also, the incubation period for Salmonella can be long or short. Your husband just had major surgery and fasted for at least twelve hours before that. His stomach was moving slower than normal and his resistance was weaker, making him much more vulnerable to infection.”

Zhou Can offered a logical medical explanation.

After a short pause, he looked at the family seriously. “I’d recommend you get a blood test as well. Salmonella is hard to completely eliminate with stomach acid. It can resist the body’s immune defenses. You might have a stronger constitution, but if you drank contaminated soup, there’s always a risk.”

Doctors can only give advice. Whether patients or their families follow through isn’t up to them.

“Um… Just check my husband first! He’s the one suffering right now. Please do something and help him.”

The family member hesitated, clearly unwilling to follow Zhou Can’s suggestion.

Zhou Can didn’t push any further. He glanced at Yu Xin—it was her job to order the tests.

After all, she was the one managing the case.

She still had a bit of doubt about Zhou Can’s diagnosis.

But ordering a blood test and collecting a stool sample to check for Salmonella wasn’t difficult at all.

The tests were affordable, useful for diagnosis, and harmless to the patient, so there was no reason to hesitate.

She could order them right away.

……

After that, Zhou Can had no more involvement in the case and went back to the office to discuss surgery options for the patient in bed 71 with Director Shang.

Once Director Shang approved, Zhou Can would be in charge of the surgery.

With nothing else to do, he started looking into group case files.

Internal medicine patients often had overlapping issues with surgical patients. Many cases still needed surgery to resolve.

It wasn’t quite like he’d imagined, where almost everything was fixed with medication.

No wonder surgeons complained things got tough after endoscopic surgery took off—competition clearly intensified.

It was almost ten o’clock and Director Shang still hadn’t come back or even been seen.

Instead, Yu Xin burst excitedly into the office and sought Zhou Can out.

“Dr. Zhou, Dr. Zhou, the test results are back—it’s definitely an acute Salmonella infection!” The cool, detached look on her face was gone, replaced by obvious excitement.

For any doctor, finding the root cause of a patient’s illness is a thrilling moment.

Especially when it’s a sudden unexpected case.

[Pathology Diagnosis Experience +1.]

[You successfully diagnosed a hidden, moderately difficult case. Reward: Pathology Diagnosis Experience +10.]

Experience rewards weren’t always a hundred points.

Sometimes if the surgery or diagnosis wasn’t exceptionally difficult, the system only gave ten points.

“Toxic chicken soup strikes again!”

Zhou Can wasn’t surprised by the results.

He took the news calmly.

As for the ten experience points in pathology, after getting used to the high rewards of a hundred, he barely cared anymore.

“Um… do you have experience treating this kind of infection? Maybe you could teach me more about it.”

She bit her lip, sounding a bit shy.

There was no doubt—Zhou Can’s accurate diagnosis had earned him real respect in her eyes.

Now she was basically looking up to him as a mentor.

“For a Salmonella infection, it’s all about targeted and symptomatic treatment. For an ordinary patient, you could handle it and prescribe treatment on your own. But this patient just had major surgery, and he’s not in great shape. To play it safe, you’d better report to your superior doctor right away. Since you’ve found the cause, even if you hand it over to Director Shang, it won’t reflect badly on you.”

Zhou Can had trained under several chief physicians. His knowledge, vision, and experience outshone ordinary trainees like Yu Xin by a wide margin.

Plenty of resident doctors couldn’t even compare to him.

It was like comparing an inner disciple in a martial arts sect to someone personally trained by the master—the gap was huge.

That sort of difference was impossible to ignore.

Zhou Can had a keen sense for when to act on his own and when to report upward.

With the patient in bed 73 so sick, if Yu Xin handled things right, she’d impress her superiors. But if anything went wrong, it could be disastrous—the risk was too high.

Being caught up in the case, Yu Xin couldn’t see that.

But Zhou Can could.

“So you mean if I handle it myself, the risk is really high, right?” She seemed reluctant to give up.

“Extremely high. Let me be clear—the patient could develop sepsis or septic shock any time. He’s already showing early symptoms of typhoid.”

Zhou Can’s answer was firm.

He worried she might be stubborn enough to ignore his warning and take a shot anyway.

That would be risking her entire future.

“Got it. I’ll call Director Shang right now.”

Being cautious by nature, she didn’t dare take the risk after hearing Zhou Can spell out the dangers so bluntly—especially since Dr. Zhang, who’d been in charge before, served as a warning.

She quickly finished her report.

A deep sigh of relief escaped her, and she looked obviously less tense.

“Director Shang was called for a consult in the Emergency Department and Pediatrics. He told me to start correcting the patient’s fluid and electrolyte imbalance, get IV fluids started, and that he’ll come handle things personally when he gets back.”

Yu Xin updated Zhou Can on what had happened.

“That’s good.”

Zhou Can nodded.

“I’m just worried IV fluids won’t help since he’s been vomiting so much.” She clearly wanted his opinion.

As a trainee brought into the group by Director Shang himself, Yu Xin obviously knew all about the different fluid replacement methods.

“If vomiting is really severe, go for IV fluids. It’s not that we don’t want to save patients money—it’s that we don’t have a choice sometimes.” He understood her worry.

When he started, Zhou Can always tried to keep treatment costs as low as possible.

He’d pinch every penny he could for patients.

But he almost got into trouble twice—for which Dr. Xu and Chief Shen from Orthopedics both gave him a stern talking-to.

Gradually, he realized there are times when you absolutely shouldn’t try to save on costs. If you scrimp when you shouldn’t, you might save a little money up front but end up with preventable complications and a much bigger bill in the end.

Trying to save a few bucks, you might end up spending a fortune. That’s true in life, and even more so in medicine.

After that, he learned how to choose the right drugs and materials from the chief physicians.

When treating serious illnesses, never substitute imported drugs or medical supplies with cheap domestics if the import is essential.

Some local pharmaceutical bosses were unbelievably heartless. They sold supposed cancer drugs that, when tested, had zero active ingredients, all while boasting miraculous results and charging over three thousand yuan a vial.

But in developed countries, that kind of thing is nearly impossible.

If it happened, the company would be sued into bankruptcy.

Still, some crooked dealers always find loopholes in regulations, preying on desperate patients for profit.

One day, those unethical drug makers will get what’s coming to them.

Doctors often feel helpless facing companies like that.

It’s not just some bad actors—lots of domestic drugs are ineffective, not just cancer meds. For example, local medications for gastrointestinal bleeding barely work at all; you have to use the imported ones.

Stories like that are everywhere.

Of course, lack of efficacy with local drugs isn’t always due to greed—sometimes it’s just that domestic pharmaceutical technology still lags far behind the developed world.

Yu Xin put in the orders and hurried off to treat her patient.

Zhou Can lounged in the office, reading up on his group’s case files.

Since he was new to the department, it would take two or three days to review all the cases.

Once he finished scouring the cases in his own group, he’d start going over those from the rest of the department.

The Gastroenterology Department at Tuyu Hospital had over 130 beds alone.

Even at a three-day cycle, inpatient turnover numbers were scary.

And group cases included not only admissions but also outpatients. Some procedures or simple prescriptions meant patients could recover at home without being admitted.

But Zhou Can still needed to study these cases.

It was said that Gastroenterology at Tuyu Hospital saw over 140,000 outpatient visits per year.

Do the math, and that’s at least 385 patient visits per day.

There was no way he could read through all those daily cases in one day.

He could only pick the important ones to focus on.

Not long after, Director Shang returned from his Emergency and Pediatrics consults.

Emergency room cases are usually urgent, so it made sense that Director Shang prioritized them.

Zhou Can had spent some time in the Emergency Department before. Normally, specialists only sent an attending physician to consult on most patients. The fact that Director Shang went in person meant things were serious.

“Zhou, come with me to the ward.”

Director Shang rushed in, dropped off his things, then immediately headed out again.

He was clearly in a hurry.

Zhou Can’s heart skipped a beat at his call. He’d started to worry Director Shang had forgotten about him.

But that wasn’t the case.

It was just that Director Shang was absolutely swamped.

“I went down to consult in Emergency this morning. On my way out, Director Lou grabbed me and made sure I knew to look after you. I told him you’ve been doing a fantastic job here in Gastroenterology. Honestly, even if he hadn’t brought it up, I would have looked after you.”

Director Shang spoke as they walked.

“Thank you!”

As Zhou Can thanked him, he also felt genuinely grateful to Director Lou.

He remembered a saying: when you fall for a city, it’s usually because you love the people in it.

His connection to the Emergency Department dated back a year and a half.

But it only grew deeper over time.

The Emergency Department was filled with the people he liked most: his mentor Dr. Xu, nurses like Qiao Yu and Ye Tingting, and Director Lou. They’d all made him feel a deep attachment to the place.

Director Lou had gone out of his way to ask Director Shang to look after Zhou Can. If Director Shang hadn’t mentioned it, Zhou Can would never have known.

Silent help like that was even more touching.

Walking into the ward with Director Shang, they found the patient in bed 73 already receiving an IV drip.

Yu Xin was standing by the bed, carefully recording everything and not daring to let her guard down.

“How’s the patient doing, Yu Xin?”

As soon as Director Shang entered the ward, the charge nurse and attending doctor hurried over.

The authority of a chief physician was something else.

Especially for those with real skill—they were truly respected in the hospital.

It was a tough road from medical student to resident. There were so many hurdles.

But once you made it through and became an attending doctor, life got a lot easier.

That’s why many med students go straight into master’s and doctoral programs.

It’s not because their families are rich or because they don’t want to earn money sooner to help at home.

It’s all about a better future.

With a PhD, you only need a year of work to qualify as an attending. The hurdles for further promotion are way lower than for undergrads.

If you’ve got what it takes, the higher your education, the better your prospects.

“The patient vomited again and has had diarrhea four times. He’s almost completely exhausted. His heart rate is high, and he still has a fever.” She’d been extra careful treating the man, afraid anything might go wrong.

Now that Director Shang was here, she didn’t have to shoulder all the pressure alone.

Being a senior doctor had its perks—status, pay, respect—but when things got tough, the buck stopped with them.

No matter how difficult the case, they had to face it head on.

“Your fluid replacement protocol was well done. Remember—whenever dehydration is mild or moderate, oral fluids are best. But with this kind of case, when vomiting is severe, IV fluids are essential. You did very well here, Dr. Yu.”

A quick check of the infusion confirmed Yu Xin had made the right call, earning high praise from Director Shang.

The compliment brought a bright smile to Yu Xin’s face.

She snuck a grateful glance at Zhou Can.

It was thanks to his advice.

She’d originally planned to start with oral fluids.

“If poisoning is severe or there’s any sign of shock, start IV fluids right away—whether or not the patient is vomiting. Glucocorticoids can be used when necessary.”

Director Shang explained the finer points of fluid therapy to his two trainees.

Zhou Can had picked up some of this in Critical Care, but Director Shang knew the topic inside-out.

“If the patient doesn’t have complications, antibiotics aren’t needed. But for the old, young, immune-deficient, or anyone with typhoid-type, sepsis-type, or abscess-type infections, antibiotics are a must. The typical course lasts about two weeks, adjusted as the case improves.”

Sepsis and abscesses are both very serious conditions.

Delay antibiotic treatment and the patient’s condition can worsen rapidly, even leading to death.

If you’re injured by a rusty nail, knife, or sharp object, be sure to get a tetanus shot promptly.

If sepsis develops, the cost and risks far outweigh those of a simple tetanus vaccine.