Chapter 279: The Class Monitor’s Unyielding Pride

Yang Chan was a fiercely competitive woman.

Back in Class 512, she was the class monitor, always among the top students. Naturally, she was quite proud. Yet after starting work, she never expected to be surpassed by Zhou Can, whose own grades hadn’t been anything special. To make matters worse, the gap between them only grew.

She never said anything about it, but deep down, the frustration gnawed at her.

Only by winning back a round could she feel at ease.

People—especially those with pride—crave proof they’re no worse than others.

Yang Chan and Zhou Can had always had a delicate relationship. In front of Zhou Can, she was forever the proud, bossy class monitor. But whenever Zhou Can needed help, she’d step up without a second thought, never asking for anything in return.

She believed it was her duty, as class monitor, to look out for her classmates.

This time, she wanted Zhou Can to see that she was still the strong, capable class monitor he remembered; her confidence was unshaken.

But diagnosing SAS wasn’t exactly her forte.

She was already racking her brains, trying to figure out the root of the patient’s illness. Whether she’d uncover anything, though, was anyone’s guess.

Gao Jian was also deep in the process of diagnosis.

Since the patient’s condition seemed connected to the central nervous system—and neurology was his specialty—he held a clear advantage and was working hard.

He too wanted to beat Zhou Can just once and reclaim some confidence.

These past two years, he’d felt crushed under Zhou Can’s excellence.

The stronger your rival, the heavier your own burden.

Compared to them, Zhou Can seemed the most relaxed and unhurried. He was calmly following a faint clue, digging deeper into his analysis.

While the attending physicians were busy diagnosing the young woman, something unexpected happened.

The woman, who had been propping up her huge head with both hands, suddenly slumped forward on the table and started snoring loudly.

This little accident left the doctors exchanging glances, then quietly chuckling.

“Does she often fall asleep like this at home during the day?”

Zhou Can posed the first question to the family.

“Yes! She often dozes off while watching TV on the sofa or chatting with us. After a whole day of checkups at the hospital, she must be exhausted.”

The patient’s mother looked at her daughter with clear affection.

Having raised their daughter to be this overweight, the parents couldn’t be blameless.

They say overindulging a child can ruin them.

Pampering children isn’t real love; sometimes it does more harm than good.

“Does she usually sleep for a long time during the day?”

Zhou Can wanted to know if the patient showed any signs of daytime sleepiness.

“Not at all. Her daytime naps are light, and it’s easy to wake her up.” So, no apparent hypersomnia.

“Has her snoring always been this loud?”

Zhou Can nodded and asked.

“Today is actually pretty mild. When it’s bad, you can feel the doors and even the windows shake. Doctor, does my daughter’s loud snoring mean she has strong lungs?”

The mother sounded oddly proud of her daughter’s booming snore.

Who knew there were parents like this out there?

“I’m not sure there’s any scientific basis for that!” Zhou Can made sure his tone stayed gentle; the last thing he wanted was a family argument breaking out.

From his knowledge, the louder the snoring, the more obstructed the airway.

But since the mother treated it as a good thing, Zhou Can figured telling the blunt truth would only alienate her.

With central sleep apnea, the snoring is usually mild and intermittent.

This patient’s snoring was severe and persistent, pointing more towards obstructive sleep apnea.

The three attending doctors’ diagnosis—a mixed form—seemed correct.

Diagnosing the cause of mixed sleep apnea was trickier and much more complex.

No wonder surgeries at other hospitals had failed.

Suddenly, the patient’s snoring stopped.

Her body started to squirm uneasily, her face slowly turning red as she struggled to breathe. Then, all at once, it looked like her blocked airway finally broke open.

She let out a long whoosh as stale air rushed out of her mouth.

After a moment, her breathing returned to normal.

Zhou Can and the others, including Director Zhang, had just witnessed the apnea firsthand. Past the initial shock, they were actually pleased.

Seeing the symptoms with their own eyes would surely help with the diagnosis.

When she resumed breathing, she expelled air through her mouth. Was her nasal airway the one blocked?

That gave them a new direction to pursue.

“During the apnea, her circulatory system seemed unaffected—no high blood pressure, arrhythmia, or heart attacks. That’s a pretty good sign; at least we don’t have to worry much about cardiovascular complications during her episodes.”

Zhang Bihua commented.

Sleep apnea easily leads to complications in the heart, lungs, nervous system, endocrine, and metabolism.

Those side effects can be even more dangerous than the sleep apnea itself.

“There’s also no sign of breathing difficulty, low oxygen, or high carbon dioxide. That means no risk of developing pulmonary hypertension or right heart failure. The patient’s overall condition seems fairly mild—not yet life-threatening.”

As he talked, Zhou Can circled to the patient’s side and examined her neck closely.

The family was a bit snobbish, clearly unsure about trusting such a young doctor.

They only shifted aside a little to make room.

Zhou Can didn’t mind. After all these years in medicine, he’d met every kind of family you could imagine.

A little disrespect was just part of the job.

Now that he had more standing, the higher-ups treated him well. But back during his internship, before he had any reputation, he was taking heat from all sides.

Patients and families would chew him out, then the chief resident would jump in, and sometimes the supervising doctor would glare at him like they’d just scrubbed a pot with their face.

After looking the patient over, Zhou Can felt a bit more confident.

Directors Zhang, Deputy Director Shi, and Director Jiang began discussing the patient’s case, but they’d yet to make any real breakthroughs.

“One more thing—does she ever complain of headaches when she wakes up in the morning?”

Zhou Can decided to probe a little deeper.

“Now that you mention it, yes. She often says she slept badly and her head hurts a bit,” the patient’s mother replied.

“Has she ever wet the bed?”

A clearer picture was forming in Zhou Can’s mind.

“Uh… I don’t think so.” The patient’s mother hesitated.

Her shifting gaze and quick change in expression made it clear she wasn’t being truthful.

Doctors actually have a few tricks for spotting when a family member isn’t telling the truth.

For example, if someone looks up to the left while answering, it usually means they’re making something up. If they look up and to the right, they’re trying to remember honestly.

Just now, the patient’s mother had looked up left, her eyes darting everywhere, never meeting Zhou Can’s. She was almost certainly lying.

“There’s no need to feel embarrassed in front of your doctor. Being honest about her symptoms will help us find out what’s really causing her problems. Once we do, there’s a good chance we can cure her sleep apnea and get her back to normal.”

Zhou Can encouraged her gently, painting a hopeful picture.

“Okay… My daughter has wet the bed before, but only occasionally.” The mother lowered her head and spoke quietly.

The fact that Zhou Can could pinpoint their daughter’s private symptoms earned him newfound respect from both family members.

“Director Zhang, I suggest we check the patient’s thyroid function.”

Zhou Can offered his diagnostic recommendation directly to Director Zhang.

Yang Chan and Gao Jian were both stunned; they’d never expected Zhou Can to make a breakthrough so quickly.

Of course, neither of them had ever worked in the same department as Zhou Can.

Otherwise, they wouldn’t have found it all that surprising.

Plenty of attending physicians had suffered defeat at Zhou Can’s hands—let alone two trainees like them.

Trying to measure up to Zhou Can was just begging for humiliation.

“Why do you suspect a thyroid issue?” Director Zhang didn’t rush to a conclusion, but was genuinely curious about Zhou Can’s reasoning.

Normally, central sleep apnea suggests a problem in the central nervous system, and obstructive sleep apnea points to the airways.

But Zhou Can had looked beyond both possibilities and zeroed in on the thyroid, showing a rare ability to think outside the box.

“There are several reasons. First, if you look at the patient’s neck—and based on my experience in general surgery—her thyroid looks abnormal.”

This ability to spot issues just by looking, to diagnose based on posture and appearance, required a seasoned doctor with plenty of experience.

Zhou Can had rotated through several surgery departments and performed an impressive number of operations—giving him an edge in clinical diagnosis later on.

He could pick up a tumor just by noticing changes in a patient’s complexion, for example.

Or, as now, detect thyroid problems by observing the patient’s neck.

Every doctor in the room had the basics of visual diagnosis, but their experience was far more limited—they just couldn’t match Zhou Can’s breadth.

Even Director Zhang Bihua’s expertise was mostly in obstetrics.

When it came to general surgery, Director Zhang wasn’t inexperienced but was at best a beginner.

Most directors were like that—excellent in their own field and only passingly familiar with the rest.

“Plus, when the patient underwent bronchoscopy, they found upper airway mucosal edema—a classic sign of an endocrine or metabolic disorder. She’s also easily awakened and has abnormal fat distribution and muscle laxity—again, these are linked to endocrine and metabolic problems. If possible, we should also test her bone density—this illness can lead to osteoporosis.”

Zhou Can laid out his reasoning.

These clues were missed—or dismissed—by other doctors.

“Dr. Zhou’s logic is solid and well-supported. I think we should follow his recommendations. What do you think, Directors Shi and Jiang?”

Zhang Bihua looked to the others.

“No objections here.”

Deputy Director Shi was all for it. Zhou Can represented the gastroenterology department, and any glory reflected well on Shi as well.

“Agreed! The younger generation is impressive—Dr. Zhou is talented and his diagnostic skills are top-notch. Truly admirable!”

Director Jiang had always thought highly of Zhou Can, and Director Tan in charge of internal medicine liked him even more.

Now that Zhou Can had made headway on a tough case, Director Jiang gladly added his praise.

“Director Jiang, you’re making me blush! It’s only because I have some background in general surgery that I noticed these things.” Zhou Can couldn’t help but feel embarrassed.

He wasn’t used to public praise from senior physicians, and it made him a little awkward.

He was used to keeping a low profile; these situations always left him shy.

“Since the directors agree with Dr. Zhou, I’ll order the tests for the patient right away,” Zhang Bihua decided, with no need to consult the family.

She figured, as long as the family had any sense, they’d definitely go along.

Sure enough, both family members now looked genuinely excited and hopeful.

After wandering through hospital after hospital, today they finally saw a glimmer of progress.

Until now, every place just repeated CT scans, bronchoscopies, and labs—never finding the real cause. Their daughter’s illness still wasn’t better.

“Dr. Zhou, are thyroid and bone density tests enough, or should we run more?”

The question showed Director Zhang’s modesty and practicality.

A more image-conscious director might have faked expertise and just ordered the tests without consulting a junior doctor.

They wouldn’t have publicly asked for input from a subordinate.

“That’s enough, that’s enough!”

Zhou Can nodded eagerly.

Director Zhang ordered the tests, the family gratefully accepted, and left with their daughter to get checked out.

When they woke her, the patient was groggy, asking what was going on.

Her mother told her directly, “Dr. Zhou and the other experts have figured out what’s behind your illness! Come on, let’s get your tests done. I’m so glad we came today—Tuyu Hospital’s doctors are really amazing, much better than the others!”

Her praise left every expert in the room feeling especially gratified.

It was the first time since their arrival that a family had complimented Tuyu Hospital’s doctors like this.

While a breakthrough brought joy to one group, things remained tough for Du Leng on his end.

His last two tough cases hadn’t yielded any answers—frustrated families had left cursing.

Now, with a third difficult case, he was just as stumped.

This time, though, Du Leng was learning.

He didn’t wait to be scolded again. Swallowing his pride, he turned to Zhang Bihua and said, “Director Zhang, this patient has a low-grade fever, blurry vision, hearing loss, and leg pain. Her labs show elevated liver enzymes, 52% lymphocyte count, 8% abnormal lymphocytes. Bone marrow aspiration reveals active proliferation, and her ESR is abnormal.”

Du Leng quickly summarized the patient’s basics, then continued.

“I’m only really trained in general and Jiaru surgery; this patient’s case is beyond my abilities. Please, can you and the other directors take a look?”

Humans are extremely adaptable creatures.

After twice getting knocked down by society, Du Leng had finally learned when to yield.

Any more stubbornness and he’d be left with nothing but humiliation.

Luckily, this patient’s family was a well-dressed, elegant middle-aged woman. You could tell at a glance she came from a privileged background.

If she’d had a bad temper like the first two, Du Leng would’ve been cussed out long ago.

But just because she was refined didn’t mean she was easygoing.

In fact, the carefully made-up face she wore was now icy cold—clearly showing her extreme disappointment with Du Leng’s expertise.

“Ma’am, could you please bring the patient over here? We’ll provide a joint consultation.”

Zhang Bihua addressed the family.

“Thank you, I appreciate it!”

The family came over; even her frosty demeanor softened a bit.

As they walked, she didn’t look at or acknowledge Du Leng at all.

It was obvious she’d lost all patience with him.

This young female patient looked barely twenty, with the makings of a beauty, just like her mother.

Sadly, her face was ghostly pale with red patches, dark eyes filled with pain—clear proof the illness tormented her.

No matter how dazzling someone may be, disease can quickly strip away everything.

Shape, looks, and spirit—all could be changed beyond recognition by illness.

“Has she been treated at any other hospitals?”

After collecting the file, Zhang Bihua invited them to sit.

“Yes. She’s been ill for a long time—almost two years. It started as a simple cold: fever, congestion, runny nose. We thought it was nothing—just let her rest and drink water. But days passed, and she didn’t improve. I started to worry. Her father works overseas, and I’m always busy. I didn’t pay enough attention to her…”

Regret filled every word her mother spoke.