Chapter 278: Doctors Under Pressure

After listening to the family’s complaints, Director Tian began to seriously doubt Du Leng’s abilities.

Of course, this wasn’t something she’d show in public.

Right now, her main concern was calming both the patient and their family, hoping to ease the situation.

It hadn’t been easy to invite Tuyu’s expert team for this special consultation event. Yet things kept taking unexpected turns and more trouble just kept coming.

Tuyu Hospital really should have sent a few more reliable young doctors.

Thinking of dependable young doctors, Director Tian’s eyes landed on Zhou Can.

A young doctor like Dr. Zhou was exactly the kind she could count on.

“Sir, please try to stay calm! Your wife’s case is indeed complicated, but rest assured—we’ve brought in experts from Tuyu Hospital. One specialist might only know so much, so we’ll have them consult together. We’ll do everything we can to get to the bottom of her illness, so you haven’t come here in vain.”

The family member’s expression softened a little after Director Tian’s reassurance.

“Director Zhang, this patient’s condition is a bit complicated. Would you be able to discuss her case and give your thoughts right here?”

Director Tian was essentially putting pressure on Director Zhang.

After all, the reputation of Xinxiang Maternity and Child Hospital’s specialist consultation event was on the line.

The last thing she wanted was for something small to ruin such a promising occasion.

“Of course. Once I finish up with this patient, I’ll immediately gather the other specialists for a group discussion,” Director Zhang Bihua readily agreed.

She probably didn’t want the family waiting too long either—nobody likes unhappy patients.

She glanced around at the other specialists and happened to spot Deputy Director Shi and Director Jiang from Neurology looking free.

“Director Shi, Director Jiang, you specialize in gastroenterology and neurology. Since the patient’s symptoms seem related to both, could you take a look first?”

Director Zhang Bihua was leading the team for this event at Xinxiang Maternity and Child Hospital. As team leader, she had every right to delegate tasks.

At her level though, she always chose her words carefully.

She used a tone that made it feel more like a discussion than an order.

Never the kind of commanding tone that would rub fellow experts the wrong way.

“No problem! Bring the materials over—Director Jiang and I will look through them together!”

Deputy Director Shi replied with more enthusiasm than anyone.

Zhang Bihua and Director Tian shared a surprised glance.

Everyone could tell—Shi’s eagerness probably meant he already had a decent read on the case.

Little did they know, Deputy Director Shi and Zhou Can had already talked it over and even planned to jump in first if they could.

If Du Leng hadn’t started arguing with the family, Shi might have already offered to ‘help.’

Now that the family had lost faith in Du Leng, of course they wanted a different expert for the wife.

“Honey, come on, let’s go see another specialist!”

With the paperwork in hand, the family led the wife straight to Deputy Director Shi’s desk.

Director Jiang joined them, with Gao Jian close behind.

Zhou Can quickly stood up and offered his seat.

“Please, Director Jiang, take my seat!”

Such humility made Director Jiang instantly warm to Zhou Can.

“Thank you!”

Director Jiang nodded kindly, then sat side by side with Deputy Director Shi.

Zhou Can and Gao Jian stood together for the first time.

They shared a quick smile, though Gao Jian’s eyes sparkled with eager determination.

“Dr. Zhou, it’s been almost two years since we last had a chance to compare our skills. What do you say? Up for the challenge?”

“Heh. Works for me!”

Zhou Can had never backed down from anyone.

He was honestly curious to see just how far Gao Jian had come after nearly two years.

Gao Jian always struck him as more pragmatic than Du Leng.

He probably had much stronger skills too.

This case fell mostly within the realm of internal medicine, which happened to be Gao Jian’s primary specialty. So in this competition, Gao Jian actually had the edge over Zhou Can.

After all, Zhou Can had spent his first year and a half rotating through various surgical departments.

He’d only officially joined the internal medicine residency two months prior.

Now the four of them began reviewing the woman’s test results and symptoms.

A year earlier, this woman had suffered uterine bleeding and underwent a curettage at a local county hospital. Pathology found the removed tissue was endometrium. She hadn’t had a period since.

Within six months, she developed symptoms: excessive urination, thirst, drinking lots of water and feeling constantly fatigued.

On her worst days, she could drink up to several liters of water in a single day.

At night, she was getting up every one or two hours just to pee.

She gradually developed a preference for cold water.

At the Provincial People’s Hospital, she underwent a glucose tolerance test and was diagnosed with diabetes.

The doctors there prescribed repaglinide and acarbose. After taking these for a while without any benefit, she stopped them on her own.

So she stayed home for several months, didn’t manage her diet, and noticed her urine was always foamy. But she didn’t experience urgency or pain.

A few months ago, new symptoms showed up: genital itching and increased discharge.

Over two months ago, things got worse—she started having episodes of confusion, slowed responses, and sometimes couldn’t communicate at all. Sometimes she grew so disoriented she’d wet herself.

Her husband worried things would just keep getting worse, so he rushed to get her checked again.

Their first stop was still the Provincial People’s Hospital.

For many locals, the People’s Hospital is a trustworthy choice—affordable, reliable care.

This time, they saw a urology specialist.

The expert ordered a water deprivation test and a pituitary MRI. The results showed a thickened pituitary stalk and high prolactin, so she was diagnosed with type 2 diabetes and hyperprolactinemia.

The report also mentioned diabetes insipidus.

That specialist probably suspected it, but wasn’t ready to say exactly what kind just yet.

They prescribed pioglitazone, acarbose, and gliclazide XR for blood sugar control.

She was also given desmopressin and bromocriptine for her excessive urination.

After taking desmopressin, her urination decreased noticeably—but it didn’t last. Within a few hours, the excessive urination returned.

After coming home from the hospital, she kept taking desmopressin and the other meds.

All these prescriptions were from that specialist.

There was definite improvement.

But after using desmopressin for so long, she started gaining weight, so she stopped the medication. On a relative’s advice, she switched to traditional Chinese medicine.

But her thirst and urination only got worse on the new treatment, and she grew even weaker.

Two days ago, she started rambling incoherently, lost touch with reality, even failed to recognize her own husband. She became limp and shaky, more often wetting herself.

Now, she had to be put in large diapers and changed every so often.

Desperate, her husband brought her to Xinxiang Maternity and Child Hospital.

Only after Zhou Can finished gathering her medical history did he realize just how complex the case was.

“Has it really been over a year since your wife’s uterine curettage and she never had another period?” Zhou Can asked the husband.

The woman now acted almost like she was mentally disabled and couldn’t communicate.

“Yes.”

The husband’s brow was furrowed in deep worry.

Just then, Yang Chan walked over to help with the case.

“Yang Chan, since the patient hasn’t had a period in over a year after her curettage, what do you think the likely cause is?”

Zhou Can took the initiative to discuss the case.

When it came to gynecology, Yang Chan had learned a lot directly from Director Zhang Bihua.

Even though she’d only been training for less than two years, she was already more knowledgeable in this area than Zhou Can.

“What about your thoughts?”

Instead of answering, Yang Chan posed the question back.

“Her imaging shows a mass around the pituitary stalk, so I think a problem with her hypothalamus or pituitary is most likely.”

To tackle tricky cases, Zhou Can always started by finding a breakthrough, then pieced things together with careful analysis.

This diagnostic approach had never let him down.

“Causes of amenorrhea can range from problems with the uterus, hypothalamus, pituitary, or ovaries. Since she had a curettage, the uterus should also be considered a priority for investigation.”

Yang Chan listened to his opinion before adding her own thoughts.

Zhou Can couldn’t help but smile—she was deliberately reminding him who the class monitor was.

Frankly, the chances of uterine problems were slim, but she had a point—it never hurt to remind everyone she still knew a bit more than he did.

Still, considering the patient also showed signs of diabetes insipidus, ruling out the uterus truly was necessary.

Zhou Can went through her records once more and quickly eliminated the possibility of uterine disease.

She had a thickened pituitary stalk, which could also cause diabetes insipidus.

“Director Jiang, can a thickened pituitary stalk result in central diabetes insipidus?” Drawing on his surgical experience, Zhou Can recalled a similar case.

That patient developed central diabetes insipidus due to a pituitary lesion.

“Dr. Zhou is really skilled. No wonder Director Tan from our internal medicine department holds you in such high regard! I’m looking at it the same way, and since you brought it up, I think it’s time for a desmopressin suppression test and a follow-up MRI of the pituitary region.”

Director Jiang from neurology had still been on the fence.

But hearing Zhou Can suspect a pituitary issue behind the central diabetes insipidus made up his mind about the tests needed.

“The last time we were at Provincial People’s Hospital, my wife already did that pituitary MRI. Dr. Du also said those results are valid. Do we really have to do it again?”

The husband grimaced—he hated having to repeat tests.

Most patients and their families dreaded facing another series of tests.

Hospitals had built a bad reputation for excessive testing.

Didn’t matter if the patient was sick or not, they’d run every test under the sun.

“I strongly believe a repeat is necessary.”

Director Jiang spoke with firm conviction.

The husband hesitated for half a minute before finally saying, “Alright, I’ll have my wife retested. I trust the specialists aren’t just piling on tests to make a quick buck.”

The truth was, there was a subtle warning buried in those words.

After that incident with Du Leng, the husband was clearly no longer easy to please.

The doctors exchanged glances without saying anything.

Director Jiang went ahead and ordered the tests.

“Go ahead. Don’t worry, even if we have to work overtime, we’ll figure out her real problem. Still, keep in mind some tests, observations, and meds take time to see results. If you trust us, you’ll need to be prepared for her to be admitted. To be straightforward, her situation is very complex—no doctor can guarantee a full cure. All we can promise is we’ll give it everything we’ve got.”

Director Zhang Bihua had just finished with her previous patient and came over.

Female doctors, especially those with years of experience, had a natural way with families.

Patients and families easily placed their trust in warm, highly experienced female doctors.

“Thank you, Director Zhang. Thank you all!”

The husband seemed visibly relieved after hearing her words.

He even managed a rare, grateful smile.

A great doctor needs more than just medical skill—they have to be excellent communicators, too.

As the family escorted the wife off for more tests, Director Zhang Bihua picked up her records and studied them carefully.

Meanwhile, there seemed to be more trouble brewing on Du Leng’s end.

“Did you buy that PhD? If you can’t diagnose my daughter’s problem, nobody else here can. If you’re not up to it, just say so—stop wasting our time!”

The overweight girl’s father was shouting at Du Leng.

Du Leng looked utterly embarrassed.

At this point, his mind was probably a mess—a mix of regret and panic. Putting on a show can be fun at first, but there’s a price to pay after.

He’d spent all morning showing off, soaking up all the attention and admiration.

Now bad luck was coming at him non-stop.

There were three cases today, all extremely tough. If he was honest, he didn’t have a clue about any of them.

Earlier, surrounded by patients and families, he was quick to order tests just to seem decisive. Maybe he’d overestimated his own skills. When the results came back, he still didn’t have answers.

He had no idea what was causing the illnesses.

If it were an ordinary day, this wouldn’t have been such a big deal.

It wasn’t rare for tough cases to stump a consulting doctor.

Especially these hard-to-diagnose cases—coming up empty was perfectly normal.

But today was different—with all eyes on him at this public clinic, and after fighting with a patient’s family earlier, it just kept spiraling.

Now here was another case he couldn’t crack—making things go from bad to worse.

Du Leng could feel the stares, noticing more and more people watching him.

Being watched, failing in public—he felt deeply ashamed, even a little afraid.

“Sir, please calm down. Bring your daughter here and a few of us doctors will look over her case together.”

Director Zhang Bihua quickly stepped in to mediate.

The last thing they needed was more shouting—what would the other families and patients think?

If the staff at Xinxiang Maternity and Child Hospital heard, they’d be the butt of jokes for weeks.

So the family brought their severely overweight daughter over.

Zhou Can was intrigued by her case of sleep apnea syndrome.

This kind of illness really needed a consult with a respiratory specialist, if only it were easier to get.

It was rare to see in daily practice—today’s case was a great learning opportunity.

Once the senior doctors had given their opinions, Zhou Can started reviewing the records himself.

He couldn’t shake the feeling that her neck looked oddly asymmetrical.

His extensive diagnostic experience from general surgery rotations came in handy now.

“Upper airway mucous edema should be one direction to consider.”

After reviewing everything, Director Zhang Bihua was the first to offer a diagnosis.

“The enhanced CT scan didn’t find any tumors, but edema of the upper airway is unusual. I’ve diagnosed plenty of obese patients, but rarely seen mucous airway swelling like this.”

Deputy Director Shi added his own insights.

Having so many specialists combining their strengths was a huge advantage compared to working alone.

“Sleep apnea syndrome comes in three forms: obstructive, central, and mixed. I think her case qualifies as mixed sleep apnea syndrome.”

Director Jiang wasn’t about to let the neurology department fall behind and chimed in with real contributions.

At the back, young doctors Gao Jian, Zhou Can, and Yang Chan stayed quiet for now.

All three were eager for a chance to prove themselves.