Chapter 258: A Difficult Diagnosis

He started pressing down on several spots across the patient’s abdomen.

When his hand found the upper abdomen near the right side, the patient let out a muffled groan.

“Ow, ow!”

She cried out, her voice trembling.

Zhou Can didn’t stop there. He continued testing the surrounding areas, but the patient didn’t react to any of them.

After pressing all around, he returned to that spot and pressed again, closing his eyes to focus carefully on what he felt.

If it weren’t for his serious expression, the family might’ve thought this doctor was taking advantage of their daughter.

“Alright, I can basically pinpoint the lesion to a section of the jejunum. That lines up with the gastrointestinal imaging results. Most duodenal issues tend to be inflammation or ulcers. The ileum often gets inflammation, ulcerations, or bleeds. But in practice, malignant diseases crop up most in the jejunum.”

Dr. Chi, also a physician, understood immediately after hearing Zhou Can’s assessment.

Sometimes, even after finding the cause, you need to be gentle when delivering the diagnosis. If you just say, “you have a terminal disease,” the patient could break down on the spot.

When people go to the hospital, they’re usually on edge.

So you’ve got to consider what they can handle emotionally.

“Doctor, what exactly is wrong with my daughter?”

The moment the family member heard something was off, their face turned pale.

There’s nothing stronger than a parent’s love.

Their children are like a piece of their own hearts.

Hearing their daughter might have a serious illness filled them with dread.

“We’re still only at a preliminary diagnosis, so don’t get too worked up just yet. From what I see, she’s doing alright so far. There’s only one spot that really hurts, and that’s actually a good sign. It means you brought her in early, and we’ve probably caught this at an early stage.”

Zhou Can explained to the family.

Now he finally understood why monks in temples liked speaking in riddles.

Sometimes, telling someone the cold hard truth won’t help—they might not accept it. Letting them figure it out can actually be kinder.

“Dr. Chi, I recommend we do an exploratory laparotomy. Of course, if possible, talk it over with the family beforehand. If we need to operate, we might as well take care of it all at once, keep the surgical risk as low as possible.”

Zhou Can’s suggestion startled not just the family, but even Dr. Chi.

An exploratory laparotomy is a pretty invasive procedure, usually reserved for life-threatening or suspected malignant diseases.

“Can’t we do a colonoscopy?”

Dr. Chi asked, his tone serious.

“Probably not. If a colonoscopy could find it, her diagnosis wouldn’t be so tough. My advice is to proceed with exploratory surgery.” Zhou Can’s firm stance made Dr. Chi take this even more seriously.

He knew all too well what Zhou Can was capable of.

Zhou Can would never insist on this unless he was sure.

“Dr. Zhou, can you explain the reasoning behind this exam?” Dr. Chi wouldn’t agree to it without a clear basis.

He decided to hear Zhou Can’s reasoning first.

“Doctor, my daughter is still so young and not even married. If she has abdominal surgery, she’ll be left with an ugly scar. That might affect her future relationships and life. Please, be very careful with this decision. If you can avoid it, please do.”

The family quietly pleaded from the side.

For families, when doctors decide on tests or treatments, their say is limited.

It’s usually the doctors who decide.

Families and patients rarely have a say since they don’t understand medicine.

Once in the hospital, they pretty much have to trust the doctors and nurses with their lives.

Thankfully, most doctors and nurses are upright, kind, and very compassionate. As the law continues to improve, the rare few who misbehave will face ever-stricter consequences.

Hospitals with real integrity have many veterans protecting medical ethics.

Take Tuyu Hospital for example.

Anyone lacking medical ethics won’t get far here.

“Let’s go talk outside. We don’t want to disturb the patient’s rest.”

Zhou Can glanced at the girl in bed and led the way out.

“When I was pressing and palpating earlier, I clearly felt what might be a hard nodule or tumor inside her abdomen. Combined with her symptoms, it points toward a malignancy. I’ve seen similar cases in the Critical Care Department where patients came too late and lost their chance for surgery. She’s so young, I think her life is far more important than any scar.”

Zhou Can said this for both Dr. Chi and the family—hinting that the girl’s illness is likely malignant.

He took them outside so the patient herself wouldn’t be burdened.

“Doctor, what disease does my daughter really have? What do you mean by ‘malignant tumor’?”

The girl’s mother asked nervously.

Even if they weren’t experts, the family could tell how serious things had gotten.

By now, they’d realized the problem might be dire.

But with Zhou Can looking so young, the family still doubted his skill and experience. Deep down, they were hoping their daughter was so young that nothing serious could be wrong.

“Malignant tumor is just the medical term for cancer. Tumors can be benign or malignant. Benign ones aren’t as dangerous, but if a malignant tumor spreads, life’s on the clock.”

After Dr. Chi’s blunt explanation, the girl’s mother went completely pale, swaying as if she might collapse.

Thankfully, her husband caught her just in time.

“It’s only a preliminary diagnosis right now. Until we get a final result, try not to lose heart. Besides, Dr. Zhou already said your daughter got treated early. Even if the outcome isn’t great, it’s not the worst-case scenario.”

Dr. Chi quickly tried to comfort the family.

“So, you really think my daughter must do this exploratory surgery? Is it dangerous to open up her abdomen?”

When it mattered most, it was the father who held it together.

The girl’s father was shaken by the terrible news, but he managed to stay calm and step up.

“Every invasive procedure carries risk, but our hospital has a lot of experience with these. The odds of something going wrong are one in a million. Before surgery, an anesthesiologist will assess your daughter’s health. We’ll only go ahead if it’s considered safe.”

Dr. Chi did his best to ease their fears, but kept things honest.

If by some chance something did happen, well… they’d have to accept it as that rare one-in-a-million case.

Doctors need a touch of persuasion to do their jobs well.

“You’re sure a colonoscopy won’t work?”

The father tried one last time.

“If the tumor’s inside the intestine, a colonoscopy would catch it for sure. But if it’s outside, the scope can’t reach it. Especially in the early stages, malignant tumors can hide really well. Because your daughter’s case is complicated, I asked Dr. Zhou to help consult so we don’t misdiagnose anything.”

Dr. Chi explained.

“Can I just say something? Please don’t take it the wrong way—Dr. Zhou looks so young. Are you sure he can get this right? Could we have a more senior doctor check too? Opening someone up is a big deal. Can’t be too careful.”

The father finally voiced his doubts about Zhou Can.

After all, Zhou Can was very young.

It’s rare for someone in their twenties to have impressive medical skills.

“Hmm… alright. I’ll bring in a more senior chief physician to take another look.”

Dr. Chi agreed.

“Thank you for helping out today, Dr. Zhou. Once I get Director Shang or Director Zheng to check her over, I’ll get back to you. I’ll definitely share your diagnosis with them.”

The family’s doubts put Zhou Can in an awkward spot, and Dr. Chi tried to smooth things over.

“You’re welcome. If there’s any trouble, just let me know. But this can’t be delayed. I’ll head back to work—take care.”

With a quick wave, Zhou Can turned and left.

He hadn’t been gone long before Dr. Chi, sensing how serious this was, hurried off in search of a chief physician for help.

Director Shang wasn’t around, so he found Director Zheng Hongtao.

The directors are all busy, but they care deeply about their patients.

Director Zheng Hongtao personally joined Dr. Chi for a bedside exam.

After reviewing her chart, Director Zheng paused to think.

“It looks a bit like intestinal tuberculosis. You could try anti-tuberculosis therapy first, then investigate further.”

“Er… Director Zheng, actually, I already asked Dr. Zhou Can to come consult as well.” Dr. Chi hadn’t expected Director Zheng’s diagnosis would line up with his own.

He suspected this time Director Zheng might be mistaken.

So he quickly mentioned Zhou Can’s involvement.

“Oh, Dr. Zhou was here too? What did he think?”

Director Zheng’s thick eyebrows twitched—clearly, he respected Dr. Zhou Can’s opinion.

“Dr. Zhou recommended exploratory surgery to confirm the diagnosis. He said he could feel a definite nodule or mass in the abdomen. Before leaving, he stressed this couldn’t be delayed.”

Dr. Chi quickly summed things up.

“Ah… Why didn’t you say so sooner? Dr. Zhou Can’s diagnostic skills are on par with mine, and he wouldn’t suggest surgery unless it was truly called for. Let me have another look. My earlier exam wasn’t as thorough.”

Hearing that Zhou Can had recommended surgery, Director Zheng’s face changed instantly.

He immediately shifted his stance.

As a chief physician, he couldn’t be publicly contradicted by a junior doctor.

And after observing Zhou Can for a while, he’d found that if Zhou Can said a case was serious, he was almost always right.

The family by the bedside wore complicated expressions after hearing this.

From the senior Director’s reaction, that young doctor from before must be more capable than he seemed!

Director Zheng had just said that Dr. Zhou Can’s diagnostic skills were as good as his own.

Hard to believe someone so young could rival an experienced chief physician.

Guess you really can’t judge by appearances.

After a moment, Director Zheng finished re-examining the patient.

“While I didn’t find anything especially alarming, Dr. Zhou wanted exploratory surgery for good reasons. The patient’s symptoms do lean toward a malignant tumor. I recommend you agree to the procedure, but ultimately, the decision is yours.”

Director Zheng was gracious enough not to insist completely.

He didn’t shamelessly echo Zhou Can’s exact words.

Still, he stressed the importance of getting the family’s consent.

“Since you say so, we’ll do it. Please schedule the procedure as soon as possible, alright?” The girl’s father looked weighed down.

He’d been clinging to hope.

But after meeting Director Zheng, he realized that young Dr. Zhou was likely right.

Zhou Can’s warning not to delay had made the father anxious.

He just hoped for a quick diagnostic answer so treatment could start soon.

It hadn’t been easy raising his daughter to this age.

If anything happened to her now, they’d never recover.

“She needs to fast before this exam. From now on, no food and preferably even no water. I’ll put in the request for the exploratory surgery right away. The anesthesiologist will come by soon to discuss surgical risk and get consent forms signed.”

Dr. Chi was relieved to see the family so willing.

He got their arrangements started on the spot.

…

The next day, right after making his rounds, Zhou Can was approached by Dr. Chi.

“Dr. Zhou, the patient’s family agreed to exploratory surgery. I explained everything beforehand, just like you said. If we find a tumor, we’ll remove it during the same procedure.”

Recovery after exploratory surgery takes a while—over a month.

Getting everything done at once is the best outcome.

That way, the patient won’t have to suffer through two surgeries.

“That’s great! The family is much more open-minded than I expected.”

Zhou Can smiled.

“Um…do you have a moment? You’re easily the best surgeon in our department. Could you help with this procedure?” Dr. Chi asked, almost like a kid afraid of being turned down.

“Sure, no problem. But if we find a tumor and need to remove it, I can do it, but I don’t have the rank for it. Plus, our gastroenterology department isn’t equipped for those procedures, so we’ll have to wheel her over to General Surgery for safety.”

By now, Zhou Can’s surgical skills were top notch.

He could handle surgeries that most associate chief physicians did solo.

Challenging dissections and removals were all manageable with his Rapid Surgical Technique—sometimes he could even perform at a chief physician’s level.

His only weakness was his current job title.

He was still a resident in training, barely getting started.

Others at this stage celebrated just stitching wounds. Zhou Can could already open abdomens, chests, and even skulls on his own.

He was on a whole other level compared to regular trainees.

“General Surgery is all set. We’ll use the new Gastrointestinal Surgery operating room. They’ll have an associate chief physician supervising. We just need someone from our department to actually perform the operation.”

Dr. Chi’s sneaky maneuvering made Zhou Can shake his head with a wry smile.

Looks like Dr. Chi had this planned all along.

Coordinating a joint surgery like this is never simple.

Even within the department, not every surgeon is up to par.

There are plenty of surgeons whose skill isn’t all that great.

To get things moving, Dr. Chi found a mediocre associate chief to skirt the rules, then asked Zhou Can to be lead surgeon. This workaround might get some criticism, but it works.

“Dr. Chi, so you’ve been planning to rope me in since the start, huh? How could I say no?”

Zhou Can couldn’t help but laugh.

“Heh, what can I say? You’re a star in General Surgery. When I told the associate chief from GI Surgery you’d be the lead, he agreed immediately. Said you’re fast, steady, and just as skilled as any ordinary chief physician.”

Dr. Chi grinned, clearly proud.

Zhou Can could only rub his nose and smile awkwardly.

Fame comes with its own risks.

A plump pig catches the butcher’s eye. A famous person draws more attention—and heavier workloads.

“They’re giving me too much credit—putting me on chief physician level. Are we heading over now? I need to help Director Shang with clinic duty a bit later.”

At this point, Zhou Can was one of the busiest doctors around.

Maybe even busier than the chief physicians.

He handled clinics, surgeries, patient management, and tough case discussions nonstop.

“Yeah, we should head over. The patient’s prepped and ready—just need to wheel her over.”

Dr. Chi was the cautious, thorough type.

Whenever he asked Zhou Can for help, everything was ready to go.

Together, they pushed the patient to Gastrointestinal Surgery.

Thanks to a recent division dispute within General Surgery, Zhou Can’s reputation soared. In General Surgery, he was now as well known as any director.

As they wheeled the patient down the hall, doctors and nurses greeted Zhou Can left and right.