Chapter 277: Under Pressure in the Diagnosis Room

Du Leng took the test results, a pensive look on his face as his brows drew together.

Clearly, this wasn’t an easy case to diagnose.

His medical knowledge was solid—far above most chief physicians. He had a knack for detecting anomalies in test data and zeroing in on the cause.

But diagnosing a patient takes more than encyclopedic knowledge.

Otherwise, with today’s advanced AI, all medical knowledge could be loaded into a computer and it alone could make the diagnosis.

A doctor can study a lifetime and still know less than one ten-thousandth of what an average computer can memorize.

In raw memorization and data storage, computers completely outclass humans.

It might take us over half an hour to memorize a single passage, and that’s just basic recall. If we don’t review, we forget before long.

But storing that same passage in a computer? Just copy and paste—it takes a split second.

And as long as the hard drive doesn’t break, the memory never fades.

There’s no such thing as forgetting or blurry recall with machines.

Yet the truth is neither computers nor AI can truly replace doctors.

There are simply too many variables to weigh when diagnosing illness.

And diagnostic logic is endlessly complex—you have to apply medical knowledge flexibly, not by rote.

“Dr. Du, could you please tell me—what exactly is my wife’s illness?”

The family member saw Du Leng silent for too long and grew anxious.

With his wife’s life on the line, how could he not be worried?

“Ah, well… from her blood counts and urine test, we’ll need to check her blood sugar next. The root cause might be connected to her type 2 diabetes.”

Du Leng was capable of seeing patients on his own, and he had a natural talent for talking his way through tough questions.

Honestly, every doctor needs to master the art of smoothing things over.

Even if you’re just working in the inpatient wards, never seeing outpatients yourself, you still deal with families and patients. If you can’t talk them around, you’re in for a world of frustration.

Sometimes, even when you did nothing wrong, a family member lays into you, and your boss comes down on you too.

Every rookie doctor has gotten caught in the middle like a scapegoat—no matter what they do, it’s wrong.

When grievances pile up, sometimes all you can do is grit your teeth, swallow the bitterness, wipe your tears, and remember the lesson.

Some sharp med students pick up these lessons early. Even if they’re not as skilled as the quiet ones, they know how to get along with families and patients. They earn the respect of their superiors, too, since they get things done.

“We just had her blood sugar tested at Provincial People’s Hospital a few days ago. Can we use those results?”

The family member was getting annoyed.

The female patient sat in a chair, her limbs shaking uncontrollably, hands and feet powerless. She needed her family to steady her so she wouldn’t tip over.

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Given her condition, running from one test to another really wasn’t easy.

“It’s been quite some time since the last test. If I relied only on those results, I wouldn’t be doing right by the patient. Look, the pituitary MRI you brought from the outside hospital was useful, so I didn’t make you repeat it. I understand it’s tough. If I can save you time and cut your costs, I’ll do my best.”

With a few well-chosen words, Du Leng won the family over.

They quietly took his advice and went to get her blood sugar checked.

Zhou Can admired Du Leng’s way with words, quietly making mental notes.

Once that patient left, a new one took her seat at Du Leng’s desk. Having so many patients come specifically to see him was enviable.

Meanwhile, Deputy Director Shi and Zhou Can still hadn’t received a single patient all morning.

Their tally of zero consultations was almost embarrassing.

Director Zhang Bihua, on the other hand, had seven or eight patients and families crowded around her table. The little line finally lent the specialist clinic the right atmosphere.

In pediatrics, Director Dai was busy too.

Two more experts from obstetrics were also caught up with their own patients.

Even the associate chief physician, known for treating infertility, now had several patients at her table.

But as for Deputy Director Shi from gastroenterology and a balding, middle-aged associate chief from neurology—their stations stayed deserted as they watched everyone else work.

“Sitting here is just too humiliating! If we’re still at zero by closing time, I’ll call Director Shang and just head back to Tuyu Hospital.”

Deputy Director Shi couldn’t keep up appearances much longer.

It felt like they were zoo animals—the families and other patients just watched them, killing any sense of pride.

“Don’t worry, Director Shi. I think that woman with excessive thirst just might have something to do with our department too. Why don’t we jump in later and at least grab our first case?”

Zhou Can offered a strategy.

If they left today empty-handed, how could the gastroenterology department ever look the others in the eye?

There’s some overlap between excessive water intake and gastrointestinal issues.

Though the woman’s case might well be more a gynecological problem.

But in medicine, boundaries blur. Many cases span across departments. Sometimes you need a multidisciplinary team to puzzle it out.

“But that patient looks incredibly tough to diagnose. If we jump in and can’t crack the case, won’t we embarrass ourselves even more? The Provincial People’s Hospital is no slouch—in some fields, it’s ahead of Tuyu Hospital. If their doctors couldn’t figure it out, what are our chances?”

Shi wanted to take a case, but he hesitated. He didn’t want to shoot himself in the foot.

He just wasn’t ready to get involved.

“I watched her closely just now. She’s dull-minded, limbs shaking, almost limp. Looks a lot like a syndrome I’ve read about. I can’t guarantee a cure, but I’m at least forty percent confident in my hunch.”

Knowing how cautious Shi was, Zhou Can decided to reassure him first if there was any hope of taking the patient.

“You really think you have a forty percent chance?”

Shi knew exactly what Zhou Can was capable of.

When it came to especially tricky or rare diseases, Shi didn’t have a clue where to start. It was like asking a regular middle schooler to solve an olympiad-level math problem.

He had no idea which angle to even try.

“Have I ever joked about this sort of thing?”

Zhou Can’s expression was dead serious.

“Fine, I’ll risk my reputation for once. If we can’t figure it out, it won’t just be us—at least the docs from Provincial People’s Hospital will have failed first.”

Shi sounded bold, but it was only Zhou Can’s reassurance that let him say so.

Zhou Can didn’t expose him—he just grinned and gave a subtle thumbs-up. “You’ve got guts, Director Shi!”

“Haha, can’t sit here doing nothing all day. Director Shang’s counting on us to make the department look good!”

Shi grinned back.

With their plan set, the two quietly waited for a chance.

Meanwhile, Du Leng had no idea he was being targeted by Zhou Can and Shi. He was still frantically handling his own patients.

Watching him work, it was like seeing an armchair general draw up battle plans—lots of talk but little substance.

He poured out a heap of medical theories, citing references and speaking for ages. But it was all theory—none of it actionable.

For example, if someone had abdominal pain, the doctor might rattle off seven or eight possible causes—enteritis, colon tumors, liver cancer, stomach ulcers—and then explain the mechanism of each.

After the explanations, the patient gets sent for test after test, but the real cause remains unclear.

And in the end, there’s no real treatment plan.

Or, the doctor uses generic treatments with little effect.

After watching for a bit, Zhou Can quietly shook his head.

When it comes to reputation, the biggest danger is letting it weigh you down.

Du Leng’s talent was real, but with such a head start in life, he’d grown arrogant, seeing himself above others and unwilling to settle down and truly learn.

No matter your academic background, once you start working as a doctor, you should learn from the ground up, step by step.

If you try to skip the basics and only tackle complex cases, your skills are shaky—when faced with real challenges, you freeze up and can’t apply yourself.

If Du Leng doesn’t wake up and change, Zhou Can will leave him far behind.

Zhou Can started far lower, but learned slowly and steadily through hands-on practice.

Du Leng, on the other hand, climbed too fast—without a solid foundation, he’d only end up stumbling.

After more than an hour, the woman with excessive thirst finally came back with her blood sugar results.

Her husband supported her as she queued up behind another patient.

Once Du Leng finished with the patient in front, the woman, still clutching her husband’s arm, sat down at the desk.

“Dr. Du, we’re done with the blood sugar test. Could you take a look?”

The family member handed over the results.

“Blood sugar (venous): 52 mmol/l, Na+: 173 mmol/l, K+: 3.9 mmol/l, Cr: 165.7 umol/l…”

As Du Leng reviewed the blood sugar numbers, his face grew tense and he muttered under his breath.

“That’s some really high blood sugar.”

The family member’s nerves were obvious. “Dr. Du, is my wife’s condition serious? Is it treatable?”

“Yes, it’s serious. Otherwise, with three hospitals before us, she’d be fine by now. Even the Provincial People’s Hospital couldn’t pinpoint the cause. If the top doctors can’t handle it, do you think it’s easy? No doctor can promise a cure. All we can do is diagnose, try medications, and see how she responds.”

After a long-winded explanation, all the family could do was nod.

Just then, the extremely obese female patient came back with her test results.

Now there were two complicated cases in front of Du Leng.

The pressure on his shoulders doubled.

He shot a pleading look at Director Zhang Bihua, seated in the middle, hoping for help. But she was too busy to even glance his way.

Director Zhang had no idea what was happening on Du Leng’s side.

There’s a saying: when it rains, it pours.

Trouble never comes alone.

Now, with two challenging patients and still no solution, a new patient showed up with hearing loss, blurry vision, and a low fever—her tests were finally done too.

Facing a row of anxious patients all waiting for him to diagnose their problems and give answers, Du Leng was feeling the heat.

With just one patient, his smooth talk could work.

But facing several difficult patients at once—even the best words would sound like excuses. The families weren’t going to buy it.

The woman addicted to cold drinks with type 2 diabetes was already a tough case. Handing her some placebo to get through the moment was tempting, but if it hurt her, the risk was enormous.

If patients like her are left untreated, their conditions quickly worsen. At that point, the family won’t care about the facts—they’ll blame Du Leng for making things worse with his prescriptions. That could be a disaster.

Relatives might not spot the placebo, but the hospital or authorities could easily investigate.

So Du Leng carefully pored over every page of the test results, hesitation written plainly on his face. He just couldn’t commit to a cause or treatment plan.

“Doctor, how much longer? My daughter is too heavy to stand for long.”

The obese girl’s father started urging him.

He’d come to Xinxiang Maternity and Child Hospital hoping to catch the touring experts from Tuyu Hospital. At first, things looked promising—but after a full day of tests, he was waiting for results only to realize that this doctor from a top overseas school might not be everything he’d hoped.

Doubt slowly crept into the minds of the family.

The longer the wait, the bigger that doubt grew.

“Don’t even mention it. Waiting is so frustrating. We’ve been here all day, just hoping Dr. Du could finally diagnose the problem after the tests.”

The person behind them—another family member—chimed in.

The patient with a low fever and declining hearing and eyesight must have been in pain, judging by her pained expression. She could barely stand without help.

Exactly where it hurt wasn’t clear—maybe her legs or hips.

“Honestly, we’re all in the same boat! We had tests all day too, and still there’s no diagnosis in sight.”

The husband of the woman who drank too much cold water sounded genuinely fed up.

This kind of frustration was infectious—after so long in line, every family was getting more and more upset.

“Dr. Du, can you at least tell us what’s wrong with my wife? Give us something!”

The family member pressed again.

Du Leng didn’t have much experience in the clinic. Surrounded by impatient families, he was both angry and rattled.

“I told you—it’s not an easy case. Three hospitals couldn’t solve it. If you don’t trust me, you’re welcome to find another doctor.”

Words spoken in anger can easily become hurtful.

It’s a recipe for conflict.

The families had queued for ages, dutifully doing every test he asked, and now he was brushing them off. That was irresponsible.

“If we didn’t trust you, we wouldn’t have come. We did every test you ordered. After all this, you can’t just dismiss us.”

The family member’s cheeks were flushed with anger, their eyes serious. It was clear tempers were rising.

“My attitude is fine. I’m patiently analyzing the cause here and you keep rushing me. Like I said—if you can’t wait, find another doctor.”

Du Leng was well-educated and polite—not the type to shout back. But he could be curt if he was pushed.

Even a clay Buddha loses patience eventually, let alone someone as proud as a foreign-educated doctor.

Being questioned in public by so many, there was no way he could save face.

Unfortunately, today he ran into a family with a fiery temper.

Bang!

The family member slammed his hand on the desk, making everything on it jump several centimeters.

“You call that good attitude? Are you trying to fool us and the patient? We underwent all your tests and listened to all your theories, but now you say you can’t find the cause? You act like you’re royalty—doctors are supposed to serve the people. If you can’t treat patients, don’t sit here and waste our time!”

No one expected this family member to be so sharp-tongued—when he argued, he really went for it.

His voice was so loud the whole outpatient hall probably heard him.

The thing is, some of his points made sense.

The fight that broke out created a huge scene, grabbing the attention of Director Tian, who was still happily planning to publicize the story of the expert saving a critically ill child.

“What’s going on? Why is the overseas doctor having it out with the family?”

Director Tian was suddenly at a loss.

She thought about sending an assistant or a manager to calm things down, but worried they’d mishandle it. Instead, she rushed over herself.

“Everybody calm down, please. Our doctors work hard, and we have to appreciate that. Families and patients have it tough, too—we understand each other. Doctors and patients should work together and trust each other.”

Director Tian didn’t ask for details right away—she first tried to cool tempers on both sides.

“I’m Tian Yuxiang, director of Xinxiang Maternity and Child Hospital. If you have complaints, tell me directly. I’ll find a way to help you.”

The director kept trying to ease the hot-tempered family’s anger.

“Director Tian, please judge for yourself. Dr. Du made us do test after test, couldn’t make a diagnosis, and had an awful attitude. He told us to go elsewhere. Isn’t that infuriating?”

The family member was still furious.