Chapter 239: Busy Clinic, Elusive Diagnoses

“Take this and go pay the fee. After your tests, just bring the results back here. Once you’re done, you don’t need to wait in line again—just let the nurse outside know and she’ll let you right in.”

Zhou Can handed the lab slip to the patient.

It used to be that paying fees meant standing in long lines, sometimes for half a day before you got to the front.

Now with the rapid rise of mobile payments, paying at the hospital is quick and simple.

You’ll never see those endless queues at the payment window anymore.

“Thank you so much!”

The family member thanked him, then took her daughter and headed out.

Zhou Can opened the door for them and saw them out.

The next patient was ushered right in.

The outpatient clinic was always this busy.

A lot of people think if you spend a few hundred on a VIP specialist appointment, at the very least you deserve a full hour of detailed consultation.

Truth is, if the specialist is familiar with your condition, sometimes you’re in and out in less than ten minutes.

If you have a complicated or unclear case, you’ll either be sent off for more tests or be admitted for observation.

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So really, if you’re dealing with an ordinary illness, you don’t need to see a specialist.

A regular appointment costing just a few bucks can get you properly treated.

The tests and treatment plan won’t be any different from what the experts would give you.

“Director Shang, please take a look at me! I feel like I’m about to die!”

The patient was a man in his seventies, with rosy cheeks and a plump build.

He was wheeled in by a woman in her forties.

As soon as he entered, the old man kept groaning, looking as if he was in great pain.

“Don’t worry, you’ve made it to my office. I’ll make sure you get the right treatment. From the sound of your voice, you’ve got a lot of energy. You don’t seem like someone with a serious illness,” Director Shang reassured, all while giving the patient a once-over.

This was a preliminary visual inspection—the first step in any medical assessment.

Doctors call it ‘inspection.’

Every doctor starts with this when seeing a patient.

“No major issues, just that lately I’ve been having stomach pain, bloating. After eating, sometimes it feels like the food is about to come back up. It’s unbearable.”

The old man groaned while describing his symptoms.

The last patient came in with abdominal bloating, occasional mild pain, and felt full after just a few bites.

This time, the symptoms were located in the stomach itself, not the abdomen.

After listening, Zhou Can sized up the interesting old man.

In his mind, Zhou Can mused that, with such a robust voice and rosy complexion, the man sure didn’t look seriously ill.

But you never know—only thorough tests would tell the truth.

Plenty of people at workplace physicals look healthy, feel fine, and their coworkers think they’re in great shape.

Then the checkup suddenly reveals advanced liver or rectal cancer.

Zhou Can had seen that more than a few times.

So just looking at someone isn’t enough to rule out serious illness.

Director Shang wrote down the symptoms, asking about the patient’s medical history and any other issues.

Besides stomach bloating, pain, and food reflux, sometimes the patient had lower back pain.

As for the wheelchair, that was from a work injury years ago.

He’d had an accident in a factory, was paralyzed from the waist down, and had to get around by wheelchair since. At least he got a hefty compensation.

Back then, property was cheap. He used the money to build a shop-front and house.

He figured, even if he couldn’t work, he could still live off the rental income.

With that secured, he never had to worry about food or money again.

Turns out, luck was really on his side. The shop he built ended up in a commercial hotspot. Over the years, he’d saved up quite a bit from rent, and with the housing boom, the property’s value soared.

On top of the roughly $27–28,000 a year he made from rent, the property itself was now worth over $1 million.

So he had absolutely nothing to worry about financially.

The woman who wheeled him in wasn’t his daughter or any other family member.

She was the housekeeper he’d hired.

The old man said his wife had passed away years ago. He only had one daughter, who’d moved away after getting married. She and her husband ran a chain of supermarkets and kept inviting him to live with them, but he refused.

He thought living alone was freer.

When you think about it, seventy years old, with a live-in housekeeper attending him around the clock—life was comfortable.

His needs were met, he wasn’t short on money—of course, that made him afraid of dying.

Every little ache would send him rushing to the hospital.

This time with stomach pain and bloating, he went straight for a specialist appointment.

At his age, he’d spend all the money he had just to buy some peace of mind.

“Director Shang, give it to me straight. Is this stomach cancer? If it is, I won’t bother with any more appointments.”

After telling his story, the old man grew anxious again when he saw Director Shang thinking it over without answering.

The housekeeper leaned in close and gently comforted him.

“You’re charmed, nothing will happen to you. Just relax. Even if something does happen, I’ll be here to take care of you.”

The tone between housekeeper and old man was so close, even in front of all these doctors. Who knew how they acted with no one watching?

Zhou Can had seen plenty of stories like this online and on TV.

The housekeeper flatters her employer, marries into the family, and eventually finds ways for him to sign over the property. When he dies, the house is hers.

Some are even worse; as soon as the property is theirs, all pretense is dropped and they throw the old man out.

Zhou Can couldn’t help worrying for the old man.

At this rate, he’d surely get tricked by a pretty face.

“Huihui, you’re the one who really cares about me,” the old man said, clearly pleased by the housekeeper’s words.

Director Shang didn’t quiz the younger doctors this time. He just ordered tests for the patient.

Once they sent the patient off, he gestured for Zhou Can to hold the next patient outside a moment.

“Any of you know what that patient’s illness actually is?”

He looked around at the doctors.

“Dr. Huang, what do you think?”

By asking the attending directly, it showed that diagnosing this case wasn’t so easy.

“Probably a stomach ulcer or gastritis,” Dr. Huang Xinggui said, obviously having done his own silent assessment.

Based on the symptoms, stomach inflammation was a plausible guess.

“What about the rest of you?”

Director Shang turned to the younger doctors.

“I don’t want to jump to conclusions; I’ll need to see the test results first.”

That answer from Qiu Chengyu basically acknowledged it was beyond him to diagnose.

After all, if you guessed wrong, it could be awkward.

A vague answer was safest.

“I’d say gastritis,” Xie Lin said, lining up with Dr. Huang’s view.

“I think it could be something with the duodenum,” Luo Jingyin chimed in; she always linked everything back to the duodenum, as if she had a grudge against it.

Zhou Can was left to speak last again.

This time, it truly wasn’t deliberate. The old man’s case was just difficult to diagnose.

You can’t draw a conclusion with a handful of symptoms but no test results.

“Dr. Zhou, you nailed the last patient’s diagnosis. But this one’s challenging—any thoughts?”

Director Shang watched him, clearly interested.

Zhou Can didn’t want to kill the mood, so he braced himself and answered, “When you and Luo Jingyin examined the patient, I noticed some unusual rashes on his skin, and the paralyzed lower leg had a bit of swelling. I first thought maybe his relationship with the housekeeper was messy, causing the rash, but thinking it over, that’s probably not it.”

His words made both young female doctors blush a little.

Even at twenty-five or six, and possibly dating, talk like this could still be embarrassing.

“Considering the lower back pain, stomach issues, and food reflux, I suspect it’s eosinophilic gastroenteritis.”

That was a pretty rare disease.

It brought all sorts of stomach and intestinal upset.

When eosinophils invade, they cause reactions that look like inflammation—but it’s not the usual sort.

Only seasoned doctors or those with a sharp eye and deep knowledge could spot it.

“This condition comes in three types: mucosal, muscular, and serosal. There was no bowel obstruction, so the muscular type is out. No abdominal swelling, just mild fluid, so we can rule out the serosal type. And since he’s mainly got stomach pain, nausea, vomiting, and mild diarrhea, I’d say it’s probably mucosal infiltration.”

Zhou Can broke the diagnosis down, analyzing the type of disease at play.

He was logical and thorough, and his depth of medical knowledge impressed the group.

The two young female graduate students looked at Zhou Can with shining eyes.

Dr. Huang Xinggui was genuinely amazed.

He only now realized Zhou Can might actually be more skilled at diagnosis than he was as an attending.

Before, he’d assumed Zhou Can was only at a resident’s level at best.

Now, he saw he’d underestimated him.

Of course, they’d never heard of Zhou Can’s legendary runs in other departments. Especially that last month in General Surgery—he’d solved multiple tough cases and helped Mr. Liu crack some major mysteries.

Many of those were ones where patients had been to several hospitals and top doctors, with no answer.

Yet Zhou Can managed to identify them all.

Even as an intern, he displayed real talent for pathology.

With nearly two years of clinical training, hands-on experience, guidance from top attending physicians, and lots of self-study,

his diagnostic ability climbed quickly.

Officially, he was at the attending level now, but in reality, he was every bit as capable as a deputy chief.

For unusual illnesses, his creative approaches sometimes outshined even department heads.

“Teacher, do you think Dr. Zhou’s diagnosis is accurate? It sounds convincing to me!”

Xie Lin, in awe of the young trainee, now felt a new sort of admiration.

The old man’s case was tough—the symptoms looked routine, but the true illness was buried deep.

Getting the right diagnosis was extremely hard.

She’d guessed gastritis, same as Dr. Huang, but wasn’t at all confident in her answer.

It’s like going job hunting with an ordinary degree and almost no experience, then suddenly being offered a $2,000/month salary—anyone would be suspicious.

“My initial diagnosis was gastroenteritis, but after hearing Dr. Zhou’s reasoning, I agree—this is probably eosinophilic gastroenteritis, not your typical inflammation.”

Director Shang didn’t hide anything—even in front of students.

He openly admitted that he only considered ordinary gastroenteritis, not narrowing it down the way Zhou Can did.

“Dr. Zhou, you’re amazing! I’ll have to learn from you.”

Xie Lin gazed at him with outright admiration.

Realizing Zhou Can’s diagnosis went beyond even her teacher’s, she was quietly astonished.

“Hey, I just got lucky—like a blind cat stumbling on a dead mouse. Anyway, we’ll know for sure once we see the tests. It’s just a discussion for now.”

Zhou Can wouldn’t dare steal the spotlight in front of Director Shang.

A little modesty was the right move.

“Either way, I still think you’re incredible. I really do want to learn more from you. By the way—could you tell us what exactly the young woman in the first case had?”

The other two graduate students perked up as well.

They were all eager for the answer.

“Uh… Let me make it clear—this is just my view, and I could be wrong. Given her symptoms and the background info, I’d say it’s atrophic gastritis caused by a Helicobacter pylori infection.”

That’s a pretty common issue.

Especially in well-known hospitals like Tuyu, patients like this show up all the time.

Helicobacter pylori is a major contributor to stomach cancer.

“So that explains why you ordered all three tests for her! Man, after so much time learning from my teacher, I still feel like I know nothing.”

Xie Lin gave herself a playful smack on the head, making everyone else laugh.

A cute young woman acting silly really could brighten up a man’s day.

After all, the joys of life often come down to the connection between men and women.

If you want to sum up the world in a line or two, that’s really it.

As the old saying goes, without women, the world would just be a world—not a beautiful one.

“Dr. Zhou, how did you know the young woman was infected with Helicobacter pylori?”

Luo Jingyin, usually quiet and shy, could not curb her curiosity and finally asked.

“Maybe I just have a good nose. When she opened her mouth to yawn—even though she covered up—I could still smell the bad breath characteristic of the infection. After listening to her symptoms and considering her history, that’s how I guessed Helicobacter pylori.”

After answering, Zhou Can hesitated, then added,

“Her mother should probably be tested, too. Honestly, her breath was even worse.”

Obviously, you could never say things like that in front of a patient.

It’s too hurtful to their dignity.

With only the doctors present, Zhou Can had no such worries.

Helicobacter pylori is contagious to a degree.

Family members eating together can easily spread it—especially between couples. If one has it, it’s likely both do.