Chapter 261: A Gamble With Needles

From Zhou Can’s experience, there was almost no doubt—the patient was suffering from sepsis.

“The patient’s condition is extremely poor. Performing a liver puncture carries huge risks, and the technique has to be flawless. It needs to be successful on the very first attempt—there’s no room for any mistakes. Honestly, only someone like Director Tan from our Internal Medicine Department could pull this off.”

Director Luo clearly had his reservations.

A liver puncture is basically a thoracentesis. Healthy patients can usually handle it, but this one was already at death’s door. He reminded Zhou of a candle flickering in the wind—just a breeze could snuff out his life.

Zhou Can had originally wanted to seize this chance to perform the puncture, but Director Luo’s words made him think twice.

If anything went wrong and the patient died, he’d be the next one in trouble.

Right then, Director Luo called Director Tan.

After hanging up, Director Luo looked relieved. “Director Tan agreed to come right over and help out.”

Zhou Can couldn’t help but be curious. Was Director Tan’s puncture technique really that amazing?

At its core, the four major puncture techniques boil down to injection skills.

Any doctor who’s trained for it will have pretty similar ability at puncture procedures.

Nurses are great with injections, but they’re not familiar with puncture procedures. So even the most skilled senior nurses aren’t qualified to carry out punctures.

It wasn’t long before Director Tan hurried in.

Almost a year had passed since they’d last met, but Director Tan still looked as rosy and alert as ever—physically and mentally in top shape.

“Hey, Little Zhou, you’re here too!”

Director Tan greeted Zhou Can first the moment he walked into the consultation room.

You could feel Director Tan’s genuine fondness for Zhou Can—and the other doctors were all a bit jealous.

“My mentor couldn’t get away, so he sent me to attend the consultation. It’s been almost a year since we last met, but you really do look even younger now.” Zhou Can wasn’t just flattering him; he meant it.

Director Tan clearly took great care of himself.

“Haha, really? Looks like all those traditional Chinese health techniques I studied are finally paying off.” Director Tan grinned with pride.

The other chief physicians from the Cardiovascular Medicine Department hardly reacted, but Zhou Can was genuinely surprised. “So you’ve actually studied Chinese medicine in depth? That’s honestly impressive!”

“What, you think us Western medicine doctors can’t learn TCM? Foreigners might try to suppress our country’s traditions, but we shouldn’t fall for it. Both Western and Chinese medicine have their strengths and deserve respect. If you ask me, Chinese medicine offers deeper, broader insights into pathology and pharmacology. It’s just a shame we haven’t got the talent to really master it. Even after all my work, I’ve only scratched the surface.”

Director Tan actually extolled the virtues of Chinese medicine right here in front of everyone.

It honestly caught Zhou Can off guard.

After all, there are so few truly skilled TCM doctors these days.

There’s such a huge divide between Internal and Surgical departments.

In Surgery, everyone practically worships Western medicine. From surgical instruments to pharmaceuticals to procedural standards, it’s all about what the West does.

Strangely, the more advanced Internal Medicine specialists get, the more they respect TCM.

“Dr. Zhou, maybe you don’t know, but Director Tan’s acupuncture skills have even earned recognition from the Chinese Medicine Association! That’s why we’ve asked him to do this thoracentesis—only he can handle a high-risk operation like this.”

Seeing how warmly Director Tan treated Zhou Can, Director Luo also became much friendlier to him.

“They say acupuncture’s extremely tough to master—I had no idea Director Tan excelled in so many fields.” Zhou Can finally understood why Director Tan’s puncture skills had such a reputation.

Acupuncture is even more advanced than ordinary injection techniques.

Some of the acupoints require incredibly long needles—I’ve heard of silver needles being at least an inch, with gold ones up to nine inches long.

One inch is about 3.3 centimeters, so nine inches is close to 20 centimeters.

Just thinking about inserting a needle that long into someone, leaving only a small tip outside, is enough to give you chills.

Even now, with Level 5 Injection Technique—comparable to an associate chief physician—Zhou Can wouldn’t dare claim he could stick such a fine, ten-centimeter-plus needle safely into a patient.

But some master TCM doctors can do it easily.

They can use silver needles for acupuncture or to unblock meridians as if it’s nothing.

That’s the mysterious charm of acupuncture.

“Oh, my skills don’t count for much. Didn’t you also have great puncture technique, Little Zhou? This patient’s situation shouldn’t be that tough for you. How about you do the procedure?”

Director Tan actually knew all about Zhou Can’s abilities.

He’d clearly been following Zhou Can’s progress for some time.

“Director Tan, this patient’s condition is really critical. Maybe let Dr. Zhou practice next time?”

Director Jiang couldn’t help but jump in.

Honestly, he didn’t know much about Zhou Can’s real capabilities.

“You just don’t know what Zhou Can’s capable of! For punctures at this level, I guarantee he can handle it. I happen to know he’s already tackled even tougher operations in Surgery—more than once.”

Director Tan was brimming with confidence.

He definitely knew the inside story about Zhou Can in Surgery.

“He’s really that good? Puncture procedures are easy to learn, hard to master. Lots of doctors can do the four main punctures, but true experts are rare. Dr. Zhou’s still so young, and punctures aren’t exactly a popular specialty. Are you sure he’s as outstanding as you say?”

Director Jiang still spoke with the utmost respect to Director Tan.

But since he was the patient’s primary doctor, he’d be in hot water if anything went wrong.

That’s why he risked saying something Director Tan might not like.

“Seeing is believing. Watch him perform and you’ll know right away.”

Director Tan was absolutely certain.

Just then, a young intern burst into the consultation room with a report in hand.

“Director Jiang, Director Jiang, the sputum culture is back! The patient’s lung infection is caused by Klebsiella… Oh—hello, Director Tan.”

The intern suddenly realized the room felt a bit tense.

He did a double take—Director Tan himself was actually there.

He quickly greeted Director Tan, looking intimidated.

“You’re a diligent worker! Nice job,” Director Tan praised, eyes crinkling.

“So it really is a Klebsiella infection. Looks like Dr. Zhou’s diagnosis was spot on. The patient almost certainly has sepsis now.” Director Jiang’s feelings were mixed as he heard the intern’s report.

At least now they finally knew the cause.

The thoracentesis was now mainly to confirm things further.

Next up, he needed to focus on how to treat the patient.

“From the way Director Jiang talked, Dr. Zhou made quite an impact on the diagnosis!”

Director Tan wasn’t surprised at all.

But he was curious how Zhou Can had reached his diagnosis.

Director Luo jumped in to explain everything Zhou Can had contributed during the consultation. With every word, Director Tan’s smile widened and his attitude toward Zhou grew even more amiable.

“Let’s go—time to do the liver puncture in the ward.”

Now that Director Tan knew Zhou Can’s role in the diagnosis, his regard for him only grew.

They all filed into the ward. The patient’s condition was daunting—he looked to be hanging by a thread.

Because the puncture had to be guided by ultrasound, they moved the patient into a special operating room.

“Little Zhou, are you confident you can manage the puncture?”

“Absolutely,” Zhou Can replied, his voice steady and sure.

The nurse had already helped the patient remove his shirt and disinfected the skin.

Zhou Can got started on the liver puncture.

He found the right spot, then with a single smooth motion, punctured directly into the enlarged area of the liver’s right lobe. The biopsy sample was retrieved without a hitch and sent off for testing.

For that, he earned 101 points in Injection Technique.

A full hundred points came as a special reward.

It would take time for the biopsy and cultures to yield their results.

Zhou Can had come to the Cardiovascular Department on a mission—and in the end, rather than embarrass Director Shang, he’d brought pride to the whole Gastroenterology Department.

When he was ready to leave, Director Jiang apologized to him three different times.

He couldn’t stop praising Zhou Can for both his diagnostic skill and his puncture prowess.

“Thank you, Dr. Zhou, for helping out our department. Let me walk you out,” Director Luo said with a huge smile, the weight on his chest finally lifted now that the patient’s infection was pinpointed.

Next, as long as they treated the real problem, the patient should start improving quickly.

Catching sepsis early and acting fast are what really matter.

Thankfully, it wasn’t too late yet.

Passing by the nurses’ station, three young nurses stared in disbelief.

“Isn’t that the resident from Gastroenterology here for the consultation? Why is Director Luo personally walking him out?”

“Do you think he’s in trouble and they’re about to go confront Gastroenterology together?”

“Oh please. Director Luo’s smiling and all buddy-buddy with him. Doesn’t look like trouble to me!”

“Hey, did you notice how Director Hong from Endocrinology left earlier? He was also here for the consultation, but no one walked him out. Does that mean he didn’t contribute anything today?”

“Must be. Why else would Director Luo escort a young resident but not Director Hong? That resident’s pretty handsome, though—I wonder if he has a girlfriend.”

“You’re so hopeless. Every time you see a young, talented doctor, you fall for him right away.”

Zhou Can caught most of their whispered gossip.

He couldn’t help shaking his head. Doctors could run themselves ragged, but nobody could keep up with the nurses’ busy tongues.

What a group of gossip queens.

Back in the Gastroenterology Department, he saw there was still time left before lunch, so he made his rounds to check the patients he was in charge of. Once satisfied there were no issues, he hurried to the outpatient area to find Director Shang.

He always learned more by following Director Shang’s outpatient sessions.

Today, so many things had come up and interrupted him.

It was already close to eleven o’clock. At most, he’d only catch another hour of Director Shang’s outpatient clinic.

Zhou Can knocked on the door and walked in.

All three of the graduate students and Dr. Huang Xinggui were inside.

Dr. Huang was likely one of Director Shang’s star trainees—no matter if it was a surgery or a clinic, you’d see him shadowing Director Shang, eager to learn.

“Dr. Zhou, you’re back from the consultation already?”

Director Shang greeted him with warmth.

“The consultation went well and didn’t take too long. That patient has basically been confirmed to have sepsis—the likely cause is a bacterial infection from IV fluids. With no timely treatment, it progressed to sepsis. Both the liver and lungs developed abscesses.”

Zhou Can gave Director Shang a quick update on the case.

“Who figured out the diagnosis?”

Director Shang asked.

“Who else could it be? I bet it was Dr. Zhou.” Xie Lin piped up, grinning.

“Haha, Dr. Xie, you’re giving me too much credit. They’d already started culturing the sputum before I got there. Still, my advice did help a bit.”

Zhou Can had played a part in the diagnosis, but it’d be unfair to claim he did it all—the Cardiovascular doctors had just been thrown off by negative blood and IV fluid cultures.

That’s why they didn’t diagnose the problem in time.

But once the sputum results were out, they’d naturally consider sepsis.

“You’re just being overly modest. If you say your advice helped, I’m sure it was a big help. As long as you didn’t make me or our department look bad, that’s what matters. Next time another department asks for a consultation, you’re going in my place.”

Director Shang was hooked on this strategy and had no intention of stopping.

He was clearly intent on having Zhou Can represent him at future interdepartmental consultations.

“Aren’t you worried I might embarrass you or ruin your reputation?”

Zhou Can had worked under many mentors, but none quite as ‘hands-off’ as Director Shang.

He felt like a still-learning disciple up on the mountain whose master kept sending him out to handle all the big tasks—treating him as if he’d already graduated. The trust was a little overwhelming.

“I believe in your ability to bring me honor, not shame. Besides, who doesn’t make mistakes sometimes? It’s normal to stumble once or twice as you grow. Just do your best and don’t let it weigh you down.”

Director Shang had his back—no matter what.

Even if Zhou Can messed up, he wouldn’t be blamed for it.

“You got back just in time. This patient’s case is really complicated—an enlarged spleen, chronic fever, night sweats. Treatment at two different hospitals didn’t work, and the real cause is still unknown. Help us figure it out, will you?”

When Zhou Can had walked in, he’d noticed the patient and their family.

The whole conversation with his colleagues had only taken a few moments.

Meanwhile, the patient and their family sized up Zhou Can with curiosity.

They weren’t dumb. From the way Director Shang and Xie Lin spoke, it was obvious this young doctor was highly skilled—good enough to stand in for Director Shang at consultations.

He clearly knew his stuff.

Zhou Can picked up the patient’s records and tests from other hospitals to review.

The first hospital, a county facility, showed normal white blood cell counts and treated the patient with multiple antibiotics, but nothing worked. The patient didn’t show serious systemic symptoms, which basically ruled out bacterial infection.

Watching the patient worsen, the family lost faith in the county hospital and demanded a transfer to a bigger one.

At the next hospital, a chest X-ray showed no problems.

The patient’s main complaints were fatigue, night sweats, weight loss, and a lingering irregular fever.

The doctor there found a pea-sized lymph node at the base of the left neck—moderately hard, but not tender.

Ultrasound revealed an enlarged spleen.

Sedimentation rate was 50ml at one hour—a very high number.

Blood tests showed significantly increased globulin levels.

Taking everything together, the big hospital diagnosed a high probability of pulmonary tuberculosis.

They started a triple anti-tuberculosis treatment: isoniazid, rifampicin, and streptomycin.

A month later, ultrasound showed multiple solid masses in the spleen and swollen abdominal lymph nodes. The hospital diagnosed it as splenic tuberculosis.

Watching the situation get worse—with more complications and no improvement—the family lost faith in the second hospital.

So they brought the patient here to Tuyu Hospital, hoping for the best.

After all, this is a top provincial tertiary hospital, well-known across the region. The family arrived full of hope.

Now Zhou Can finally understood why even Director Shang looked troubled by this case.

A patient who’s tried two or three hospitals with no result is always the toughest to handle.

Being an expert is never as easy as it sounds.

The fact the patient got a specialist appointment here means at least forty percent of his daily cases are people who couldn’t be helped elsewhere.