Chapter 289: An Urgent Diagnosis

As the top specialist and head of the expert team, she couldn’t possibly accompany the patient for the exams herself.

But sending someone else just didn’t feel safe enough.

Only by letting Zhou Can escort the pregnant woman for her exams could she feel at ease.

With Zhou Can’s outstanding emergency skills, even if something happened, he could provide immediate life-saving care.

“Can I come with you?”

Mu Qing, the female reporter, sensed there was a story and followed after them.

“If you’re not medical staff, it’s best not to tag along. You might disrupt critical rescue efforts. Interviews can wait till later.”

Section Chief Tang kept his tone polite, but he was clearly turning Mu Qing down.

The pregnant woman’s condition looked scary enough as it was. If things went wrong, who knew how the media would spin it.

As head of the publicity and united front office, he had to guard against any potential PR risks.

“All right, then.”

Mu Qing, still a bit frustrated, had no choice but to back off.

…

The pregnant woman’s exams were rushed all the way with a fast-track pass.

Given her state, no one dared make her wait in line like a regular patient.

After finishing the X-rays, the pregnant woman kept complaining she couldn’t breathe, clearly in distress.

Thankfully, the chest and hip X-rays were complete.

But it would still take a few minutes before the X-ray results could be printed at the self-service station.

“Let’s give her oxygen—single nasal cannula, 28% concentration, 1.6 liters per minute.” Zhou Can noticed her blood oxygen was dangerously low. Even if the mother could tough it out, the baby inside her might not.

He started her on nasal oxygen as a precaution and decided to consult Director Zhang Bihua as soon as the X-ray results were in.

While waiting, he studied the patient’s chest X-ray.

Both of her lungs showed diffuse infiltrate shadows, but nothing else looked immediately abnormal.

In most cases, finding diffuse infiltrates in the lungs pointed to infection.

That could mean bacteria or even a fungal infection.

But since her breathing problems started the day after her fall, infection wasn’t impossible, just less likely.

Tumors could also cause this pattern—late-stage lung cancer patients, for instance.

With his limited experience, Zhou Can couldn’t pinpoint the diagnosis based on the scan alone.

There were simply too many things that could produce this kind of pattern in both lungs.

Viral, fungal, or bacterial lung infections, tumors, malignant lymphangitis, diffuse lung injury… even Director Zhang Bihua, with all her experience, might not be able to tell right away.

So all they really knew was her lungs were in trouble. Pinning down what exactly caused it would need more tests.

After waiting more than ten minutes, the X-ray results finally printed out.

The right femoral head was clearly fractured.

Director Zhang had predicted as much. No wonder the woman couldn’t stand or walk—her hip was broken clean through.

It was honestly impressive this pregnant woman managed to hang on at home for an entire night after falling.

“Can you take her blood test results over to Director Zhang Bihua right away?”

Zhou Can turned to one of the nurses who’d come from Tuyu Hospital.

“Sure thing!”

Since they were from Tuyu, it was like working with family.

Zhou Can’s orders would be carried out without hesitation.

“Dr. Zhou, what do you want to do next?”

Section Chief Tang asked, watching closely.

“I plan to bring her directly to the outpatient hall and ask Director Zhang to diagnose her cause.”

A high-risk patient like this was far beyond what Zhou Can could handle alone.

He simply didn’t have the skill—or the nerve—to shoulder that much responsibility.

“I’m just worried moving her there might disturb the normal flow of patients in the outpatient hall.”

Section Chief Tang clearly didn’t love the idea of taking her into such a public area.

Zhou Can understood his concern.

“If you think sending her to the resuscitation room instead is better, I don’t mind. But if we take her straight to Director Zhang, we can gather input from several of our hospital’s experts and get her diagnosed faster. That’s the best way to save time.”

Zhou Can was focused on the patient’s safety, while Section Chief Tang was looking out for the hospital’s public image.

He was afraid something might go wrong in front of a crowd.

And if the doctors couldn’t figure out the problem on the spot, the experts from Tuyu would look like failures in front of the media.

Probably the safest route would be to take the patient to the resuscitation room.

But since the underlying cause was still unknown, moving her there meant she’d be waiting a long time for answers. Her condition looked frightening, but her vital signs were relatively stable for now.

The onsite experts had already agreed: in a crisis, the emergency team would step in.

No specialist would drop everything mid-consult just to run to the resuscitation room for this one case.

“The doctors in the resuscitation room can diagnose her too,” Section Chief Tang insisted.

Zhou Can didn’t want to argue directly, so he glanced at the patient’s husband and father-in-law, giving them a subtle signal.

Though the pregnant woman’s husband was a farmer, he wasn’t dumb. He even had a kind of rural sharpness. Back during the war years, resourceful farmers had given their occupiers a run for their money.

They’d played innocent on the surface, while secretly fighting back in all kinds of gutsy ways.

“How could a regular doctor compare to an expert? My wife specifically signed up for a specialist—she needs real experts working on her!”

With that, he started wheeling the cot straight toward the outpatient hall.

Section Chief Tang could negotiate with Zhou Can, but there was no way to stop the patient’s family.

All he could do was watch as they wheeled her into the outpatient area.

By then, Nurse Ji You had fetched the woman’s blood test results and arrived in a hurry.

“Director Zhang, your instincts were right—her hip’s fractured. The chest X-ray shows both lungs have diffuse infiltrates.”

Afraid of delaying care, Zhou Can quickly gave Director Zhang the report.

“Any heart problems?”

Director Zhang immediately took the report and looked it over.

“I’m still pretty green, but I didn’t see anything wrong with her heart so far,” Zhou Can replied. While checking the blood results, he noticed her white cell count was normal, making a bacterial or viral infection unlikely.

This suggested her lung issue might actually be connected to her fall.

He wondered if the woman had late-stage lung cancer that had just been triggered by the trauma.

Cases like that did happen in clinical practice.

Some patients had high pain tolerance, quietly suffering discomfort for days.

Only after catching a cold or getting injured would their body finally give out, forcing them to seek treatment.

“Have you ever felt short of breath or had chest symptoms before?”

Zhou Can asked the patient.

As deputy leader of the crisis team, he had to do his part.

Helping the lead specialist track down the root cause could make all the difference.

“No… never! But the baby keeps moving a lot—is that bad?”

After getting oxygen, the woman now reported strange fetal movement.

Usually, fetal movement is obvious by three months and unmistakable by five.

“Yang Chan, check the fetal heart rate!”

Director Zhang kept frowning, trying to figure out the reason for those diffuse lung patterns.

That seemed to be at the core of her breathing problems.

Only by identifying what caused the lung damage could they hope to fix it.

Zhou Can stood watchfully by.

As Yang Chan lifted the patient’s shirt, Zhou Can noticed her abdomen was covered in bruises. Not just one spot, but everywhere.

At first, he suspected domestic abuse might be to blame.

But a closer look showed the bruises varied in size and shape.

They were scattered across her entire upper body.

“Let me check your back to see if there’s anything unusual,”

Zhou Can explained, then gently pulled back her collar to look.

Her back was the same—covered with mottled bruises.

Seeing this, Zhou Can’s alertness shot up.

Just then, Yang Chan finished checking the fetal heart.

“The fetal heart rate is still within normal range.”

Her words finally let everyone breathe a little easier.

As long as the baby was safe, that was a relief.

Fetuses are actually tougher than people think. Sometimes, even if a mother’s belly takes a hard hit, the baby manages to pull through.

One case involved a woman flung several meters in a car accident.

She was badly injured and in critical condition when rescue arrived. Though she didn’t survive, the doctors found a faint fetal heartbeat and rushed to perform an emergency C-section.

The premature infant was delivered and, after examination, was perfectly healthy.

After nearly a month in an incubator, the baby made a full recovery.

It goes to show that a fetus really is well-protected inside its mother.

Thanks to fat layers in the abdomen and the cushioning of amniotic fluid, it’s almost like the baby’s wrapped in two thick blankets.

“Class Monitor, can you check if there are bruises in her armpits and on her chest too?”

Since it wasn’t proper for him to check further, Zhou Can had to ask Yang Chan for help.

After looking, she confirmed it. “Both areas have bruises. It’s most pronounced under the arms.”

“Got it!”

Director Zhang Bihua, too, was now fully focused. She joined Zhou Can to carefully inspect the patient.

But the pregnant woman’s condition was rapidly getting worse.

Even after being put on oxygen, her breathing sounded rough and labored—like working a bellows.

She looked more and more worrisome.

Put bluntly, if she lost her breath for even a moment, it could be deadly for both her and the baby.

“Okay, open your mouth and let me see your oral mucosa.”

Zhou Can pulled on his mask and asked her to open her mouth.

She was already sluggish. He had to repeat the request several times before she managed to comply.

Since she couldn’t open wide enough, Zhou Can used a small flashlight to peer inside.

“There are similar bruises inside her mouth.”

He reported his findings to Director Zhang.

Suddenly, something occurred to him. He checked her eyelids.

“Bruising on the conjunctiva as well.”

Those weren’t injuries. There was no way this was caused by abuse.

So the bruising was a crucial diagnostic clue.

“Could this be aspiration pneumonia?” Yang Chan offered her thoughts.

“It’s possible. But her consciousness seems a bit off—never a good sign. That means her condition is deteriorating fast. If we can’t find the cause quickly, she might be gone in a flash.”

Director Zhang’s expression was deadly serious.

Now Deputy Director Shi, head of the crisis team, joined in to help diagnose.

His expertise was only in digestive diseases, so he felt a bit lost here.

Two more specialists finished with their patients and joined the growing consultation.

All of Tuyu Hospital’s experts were there, united in a tough case. One doctor’s challenge was a challenge for all.

If a patient stumped one expert, they’d tackle it together.

Teamwork mattered now more than ever.

“Director Zhang, isn’t just a chest X-ray a little too basic for her situation?”

Deputy Director Shi was sweating—she was breathing in more than out, and he was as anxious as an ant on a hot pan.

Being crisis team leader was no easy task.

How awful would it be to lose a patient your first day on the job?

“The lung X-ray looks like a snowstorm—very dangerous. Extremely high risk of death.”

Another expert chimed in with his assessment.

“This much bruising means severe bleeding under the skin.”

An obstetrics specialist weighed in too, not wanting to be left out.

Director Jiang leaned in, focusing on the patient’s mental status and head, then reviewed all her charts.

“Her head shows no major injuries, yet she’s having chest tightness, palpitations, and other neurological symptoms. So the underlying issue should be in the heart or lungs. Problems with the brain are very unlikely.”

Director Jiang was a neurology expert and brought authority to this part of the diagnosis.

The crowd of specialists kept discussing among themselves.

A few reporters swarmed in too, snapping photos like flies smelling something rotten.

Watching the chaos, Section Chief Tang’s face grew dark. He’d warned them not to bring the patient here. If something happened now, how would he ever clean up the mess?

While everyone anxiously debated, Zhou Can checked the blood report again.

Her white cell count was normal, but several other numbers were flagged as abnormal.

Coupled with all this bleeding under the skin, her blood work was essential.

“Her test shows low platelets, which matches the bruising on her upper body. I checked her legs—no bruising there, so it seems mostly up top.”

As deputy lead, Zhou Can kept contributing however he could.

“Also, her serum lipase is significantly elevated. I think we should check her blood for free fat. And it’d be ideal to test her urine for fat too.”

At that point, Zhou Can had made a major diagnostic breakthrough.

His unique skill, Life-saving Insight, gave him a sharper mind and faster thinking when treating critical patients.

It allowed him to stay uncommonly clear-headed.

“Dr. Zhou, what do you think is causing her illness?”

Hearing his analysis, Director Zhang’s eyes lit up.

“Judging from her symptoms and the data, I strongly suspect fat embolism syndrome. When I trained in orthopedics, a senior doctor once emphasized the dangers after traumatic fractures. In this case, her hip was broken after a fall, and symptoms began within 48 hours.”

“Most cases of fat embolism syndrome show up within 72 hours of a traumatic fracture.”

Every time Zhou Can rotated through a department, he got to learn from one or more chief physicians, observing clinics and surgeries with them.

He’d won their approval and absorbed all the wisdom they could share.

That was how he gained clinical experience few ordinary doctors could match.

In the end, it all came down to the valuable insight passed down from senior generations.

“Run a free fat test on her blood, now! And draw urine for an urgent test too!”

The pregnant woman was now too ill to urinate on her own.

She was barely conscious.

It would be inappropriate to insert a catheter in public—and her family would never agree. Doctors also had to respect the patient’s dignity.

“Let’s move her to the resuscitation room. Collect urine via catheter and get it tested for fat immediately. Tell the lab to prioritize this test.”

These days, most tests are automated and results come fast. Blood and urine tests can be run quickly.

But with so many patients waiting, it still felt like forever.

“Director Zhang, is it a bit hasty to say it’s fat embolism syndrome already?”

Du Leng suddenly piped up.

He was doing his best, joining the group to help diagnose.

Unfortunately, he couldn’t contribute much.

Yesterday, he and the patient’s family had argued twice. Today, he was clearly off his game. New patients didn’t realize he was all show, but he’d been tossing any tricky cases to other doctors the moment they got tough.

The result was fewer and fewer people lined up for his consultation.

Patients weren’t stupid. Standing there watching, they quickly realized this so-called overseas PhD wasn’t much use at all.

Beyond the hype, his diagnostic skills were well below the true experts.

So many people who’d registered for Du Leng quietly switched to someone else.

After all, registration was free.

Nobody wanted to put their life in the hands of someone who only looked good on paper. A doctorate or professorship might sound impressive, but what patients really cared about was who could actually cure them.

That was what mattered most.