Chapter 241: Unmasking a Hidden Illness

The patient had three MRIs in total, focusing separately on the heart, abdomen, and lungs.

But none of them revealed any issues.

He also had CT scans and X-rays, all zeroing in on the chest and abdomen. Strangely, apart from mild gastric ulcers and minor fatty liver, everything else looked normal.

The gastric ulcers healed after treatment.

His most recent tests confirmed this recovery.

The first hospital where he sought treatment was a city hospital out of province. After checking him, the doctor wrote ‘gastric ulcer’ and ‘mild fatty liver’ on the diagnostic report.

They suspected the vomiting was caused by the ulcer.

But even after the stomach healed, his condition barely improved. That doctor from the city hospital must’ve been at wit’s end.

It would drive anyone up the wall.

While the two attending physicians pondered the cause, Zhou Can picked up a brain CT that seemed a bit suspicious.

It was the only brain CT the patient ever had.

At first glance, everything looked normal. Nothing seemed off.

Still, he didn’t put the film down but kept studying it closely.

This brain CT was done at the Provincial People’s Hospital where the patient lived. They’d already examined the digestive tract and chest and couldn’t find anything. The doctor probably shifted diagnostic gears, wondering if it might be a brain tumor.

But in the end, there wasn’t any obvious abnormality.

Zhou Can also suspected the patient might have something wrong with his brain.

Heavy drinking doesn’t just damage the liver and kidneys—it can seriously hurt the brain, too.

Alcohol causes the blood vessels in the brain to constrict, reducing blood flow. That leads the cerebral cortex to become hypoxic, dulling intelligence, scattering attention, worsening memory and judgment, sometimes even causing vision issues.

Anyone who’s gotten drunk knows what it’s like—everything spins or turns upside down.

Sometimes you even see double.

Aside from that, alcohol also impairs blood supply to the brain and the nerves, leading to brain atrophy and accelerating the aging and death of brain cells.

Medical studies show alcohol is especially harmful to the nervous system.

Since this patient often drank for social events, the toll on his brain had to be significant.

That’s the direction Zhou Can was leaning toward.

Like that doctor at the Provincial People’s Hospital, Zhou Can studied the brain CT first to rule out a brain tumor.

With cancers and vascular tumors so common these days, intracranial tumors aren’t that rare anymore.

But after a thorough check, Zhou Can came up empty.

Not even the tiniest nodule under 0.5cm showed up.

He would’ve welcomed a small hemangioma—anything.

Nothing. Nothing at all.

At that moment, Zhou Can remembered a difficult case he’d once diagnosed successfully. The patient had been a student, under intense pressure from high school entrance exams, showing symptoms similar to enteritis. The eventual diagnosis was neurogenic digestive dysfunction.

Could this patient have the same neurogenic digestive disorder?

It couldn’t be ruled out.

Instinctively, he glanced at the patient.

The medical record showed the patient was forty-one, right in the age range when the pressure is highest for men.

Could overwhelming stress have caused functional vomiting with no organic lesion?

That really was possible.

“May I ask—before he fell ill, did your family face a lot of financial stress?”

Zhou Can turned to the woman.

“Not really! My husband earned a good income, and I had a stable job myself. Together, our yearly earnings were at least in the seven-figure range. Sure, work can get stressful, but my husband’s extremely optimistic and cheerful—he always took our kid and me out traveling to unwind.”

She thought for a moment, then answered sincerely.

Zhou Can’s opinion of the couple immediately rose several notches.

Anyone with a stable monthly income above twenty thousand is already part of society’s elite. However they made it—as long as it’s legal—that kind of income is impressive.

Their combined annual earnings topped a million.

With that much money, they could live comfortably in just about any city.

You really can’t judge people by appearances.

Their clothes were as average as could be.

Who’d have guessed they’d ever made so much?

The biggest fear in life is getting sick.

Before this, the male patient must’ve been successful and full of life.

But just over a year into illness, he was already a shadow of his former self.

Plenty of successful people say your health is everything. They compare health to a ‘1,’ and career success to all the zeroes that come after.

Once the ‘1’ of health is gone, the zeroes mean nothing.

“We’ve done every exam we can—repeating them isn’t likely to help. His illness is too complex. With decades of experience, I can’t diagnose his cause. In his current state, we can’t admit him for observation. Even if we do, if we can’t find the cause, our hospital really won’t be able to help.”

Director Shang had thought it all through, but couldn’t pinpoint a cause.

So he resorted to honesty: it’s time to seek another expert.

Some people might think it shameful when experts can’t diagnose a cause.

But really, throughout history, it’s common not to find the root problem. Think of the emperor’s physicians or celebrity doctors in old times—they were considered the best.

But if a royal fell ill, whole rows of doctors would kneel and beg forgiveness.

Because they just couldn’t find the problem.

There was simply nowhere to begin.

Admitting defeat is actually the safest move when you can’t diagnose the cause.

Reckless treatment on a hunch only makes things worse.

It’s a sure way to lose your head.

The woman grew anxious when she heard this.

“Please, Professor Shang, I’m begging you—find a way to save my husband! I’ve taken him to so many top hospitals and they all said Tuyu Hospital is great for digestive diseases. We’ve come so far, please, I’ll even get on my knees!”

Her determination hit everyone deeply.

For a moment, Director Shang hesitated. Admitting him wasn’t safe.

The patient’s in such bad shape, and the cause is still a mystery. If they took him in, he might not make it through his stay.

Even if the family doesn’t cause trouble, the responsibility for the doctor would be enormous.

“Get up, please! Our hospital has limits, but if there was a way, we’d never turn a patient away. Renhe Hospital in the capital has more advanced doctors and equipment than we do. You should try there.”

Director Shang tried his best to encourage them to seek help elsewhere.

He recommended Imperial Capital Renhe Hospital—a classic play used by smaller hospitals to send patients here, only now the roles were reversed.

“How can my husband travel like this? Even if we do go to the capital, we don’t know anyone there. What if they still can’t find the cause? Please, Professor Shang, have mercy and help us! I’m begging you!”

The woman’s tears and pleas were heartbreaking—she was even kneeling to Director Shang to save her husband.

Watching it all, Zhou Can couldn’t help but be moved.

When disaster strikes, most couples fall apart.

For her to stay by her husband’s side, when lesser partners would’ve run, speaks volumes.

If only they could figure out the cause.

Never mind anything else—her devotion alone was reason enough to go all out to help.

“Let me admit him, then I’ll see if I can gather some other experts in the hospital for a big consultation. If we still can’t find the cause, then we’ll be truly out of options. After that, you can always try other hospitals. How does that sound?”

Director Shang might look stern, but he’s softhearted underneath.

Faced with such a heartfelt plea, he had no choice—he had to admit the patient.

Though with all his experience, he knew if a cause couldn’t be found, a hospital stay probably wouldn’t help much.

“Thank you, thank you so much!”

The woman was overjoyed when the doctor finally agreed to admit her husband, thanking him again and again.

When patients and families face terrible illness, panic and fear take over. In that moment, the doctor is their only anchor.

Just being admitted, even if no treatment is started, can help them feel more secure.

But after admission, the hospital takes full responsibility for patient safety.

They really will try their best.

“Following the admission process, we’ll need to redo some basic tests—bloodwork, ECG, that sort of thing. Is that alright?”

“Of course! We understand.”

This wasn’t their first time in a hospital. She knew the process well.

Instead of ordering tests right away, Director Shang turned to Dr. Huang Xinggui.

“Are there any beds left in the inpatient unit?”

“I’ll call and check. Beds are always tight. I doubt it—there are a dozen patients on my waiting list alone, all hoping for a spot.”

Dr. Huang called inpatient admissions right there.

And as expected—there were no beds available.

“Let me handle this.”

Director Shang had been listening all along.

Seeing the family’s urgent faces, and knowing they’d traveled from another province, he really couldn’t turn them away.

“Hello, this is Shang Feng. There’s a patient here who came all the way from out of province. He’s seen so many doctors and still no one can figure out what’s wrong. It’s really hard for them—a woman lugging her husband, who weighs over a hundred kilos. Is there any way to get him a bed?”

Arranging a bed wasn’t easy.

Even as department director, it took all Director Shang’s nerve to ask.

“Okay, thank you!”

Director Shang hung up the phone.

And for now, the result seemed satisfactory.

“The inpatient unit says they’ll try to coordinate. If there’s really nothing, we’ll add a temporary bed in the hallway tonight. Once a real bed opens up tomorrow, you’ll get priority.”

It was already afternoon—getting a proper bed today would be tough.

A hallway bed wasn’t ideal, but it was realistic.

Sometimes, to show some humanity, hospitals put special cases on temporary beds in the corridor. At least then, medical staff can care for them properly.

They could still get medicine or IVs if needed.

“Thank you, thank you so much!” The woman knew how rare this arrangement was, and expressed her deep gratitude to Director Shang.

If he hadn’t stepped in, her husband would’ve just had to wait in line like everyone else.

Once everything was settled, Director Shang ordered the tests.

Meanwhile, Zhou Can kept pondering over that recent bloodwork report. Even when all the tests were done, he was still lost in thought.

“Dr. Zhou, maybe help pack up the test materials for the patient and let them go get checked first?”

Director Shang gave Zhou Can a nudge.

“Oh—right!”

He’d been thinking so hard he’d missed the obvious.

He quickly tucked the blood test results into a plastic envelope and handed it to the patient’s wife.

“Since you’ll be admitted anyway, if you want to leave these reports here for me to review, that’s fine. I can come back and pick them up after work.”

She didn’t look down on Zhou Can for being young.

Instead, she was happy to let him study her husband’s test results.

“When you’ve finished your admission paperwork, I’ll drop by the inpatient unit to check again. It’s getting late—hurry up and take him for the rest of the tests. If you want, you can borrow a wheelchair from under the stairs at the outpatient lobby. Carrying him looks tough—rolling a wheelchair would be easier.”

Zhou Can suggested helpfully.

Who knows, maybe families think using a wheelchair for someone who’s not paralyzed is unlucky, or maybe there’s some other reason. Even so, she’s chosen to carry someone so heavy rather than get a wheelchair.

“Thank you, thank you so much!”

She heaved her husband onto her back and almost lost her balance. Zhou Can rushed to steady her.

“Careful! Easy there!”

He helped escort them all the way out before heading back himself.

But his mind was still stuck on the patient’s mysterious illness.

Diagnosing a case this tricky means combing through every tiny clue, separating fact from noise.

It’s exhausting, and incredibly complicated.

……

Around five o’clock, she returned pushing her husband in a wheelchair.

All the hospital admission tests were done, and the results were ready.

Director Shang looked over them. Nothing serious turned up. He could proceed with admitting the patient.

A bit of background: hospitals require certain checks before admission, for several reasons. Mainly, two big ones.

First, to rule out infectious diseases—these either ban patients from regular admission or require isolation.

Second, to check for any hidden critical illnesses.

If a patient dies right after being admitted, even the hospital can’t clear itself.

That’s why it’s so important.

Director Shang himself wrote the admission certificate.

As the couple left, Zhou Can called out to them.

“Wait! I wanted to ask—when he keeps reaching up to scratch his head, is it because it’s itchy?”

Zhou Can walked over, looking the patient’s head over as he asked.

After a long time without washing, anyone’s scalp gets itchy.

He always scratched the right side of his head. Was he just too weak to reach other spots, or was it something else?

Back when the patient first came in, Zhou Can noticed he’d scratched his head four times in just half an hour.

A tiny detail, sure, but it made Zhou Can wonder.

So when the patient did it again, he spoke up.

“I’m not sure. He’s been so sick—I can’t manage to wash his head, so I just shaved him bald and wipe his scalp with a wet towel. Maybe not washing for so long made him a little itchy. Actually, he used to scratch his head like this before he got sick. It seemed like a habit.”

She remembered happier times, her eyes full of fondness.

Zhou Can studied the right side of the patient’s scalp. With no hair to block his view, he could see everything clearly.

But nothing much stood out.

Then he noticed a small, brief swelling on the patient’s scalp that quickly flattened out. It’s normal for the skin on the head to show a subtle pulse sometimes.

But right after that swelling appeared and disappeared, the patient scratched at the same spot again.

Already exhausted, the man gave up after a short struggle.

Zhou Can wanted to watch a bit longer, but they needed to finalize admission, and the workday was almost over.

He had to let it go for now.

Anyway, once the patient was admitted, he’d have plenty of chances to check him more closely.

As the workday neared its end, new walk-in patients were basically gone. Only those returning with test results for further diagnosis remained.

Director Shang was always painstaking with every patient.

He’d review each case carefully before offering insight.

Standing behind him, Zhou Can picked up a lot.

Soon, it was time to clock out.

No more patients arrived.

All those who could get their test results the same day had made it in time before closing.

“Dr. Zhou, after a full afternoon in the clinic, what do you think? Are you settling in alright?”

Director Shang asked warmly.

“It’s been a huge learning experience. I’ve picked up a lot about diagnosing digestive illnesses from you. About that patient whose vomiting couldn’t be explained—do you think it might be a brain issue?”

Zhou Can had been mulling it all day. As things were winding down, he finally seized the chance to discuss with Director Shang.

“You mean nerve problems?”

Director Shang asked back.

“Sort of, but not exactly. I’m thinking it might be another disease that people tend to overlook.”

Zhou Can shared his thoughts.