Chapter 328: New Diagnoses and Missed Connections

Zhou Can watched as the mother and her son walked away, his lips parted for a moment, but he swallowed his words in the end.

All he could do was sigh.

The only thing in this world you can get for nothing is poverty. Those two spend all day at the card table, avoiding work, so the outcome they face now was inevitable. That kind of lazy mindset runs deep in their bones. If anything is going to get them to work harder and strive for something better, it’ll have to be life’s harsh lessons combined with the advice of friends and family.

Their child is the only hope this family has left.

If his illness is cured, if he can study hard and win top honors at school year after year, maybe his parents will see there’s something worth pursuing in life. Maybe then they’ll finally think about getting real jobs.

Zhou Can quickly sent the mother and son’s names and address over to Director Tang Fei.

“OK!”

She just replied with a single emoji.

She must be swamped. After all, running such a big department, her workload is easily ten times what an ordinary attending physician faces.

Zhou Can had barely finished messaging Director Tang when new patients started streaming in.

He dove back into work like a spinning top pushed to the limit.

He thought afternoons would be slower, but people just kept coming. One after another.

By a little after three, he’d already seen sixteen or seventeen new patients.

He never expected his first official day on duty would be this busy.

Thankfully most of the cases were common illnesses. So far, only that little girl with cold-like symptoms remains undiagnosed.

After finishing with his current patient, Zhou Can got up and walked to the door.

“Are you busy right now?”

He called out to the triage nurse.

“Dr. Zhou, just say the word if you need anything. No matter how busy we are, your requests always take priority!”

Most of the triage nurses are older—the kind of people the system tends to overlook.

A lot of them got hired through open recruitment or came from technical schools.

With low pay and low status, even the most ordinary resident doctor still ends up someone they need to please.

The invisible pecking order here isn’t so different from the old feudal kingdoms.

People lower down the ladder find ways to curry favor with those above, hoping for a little help or protection at work. At the very least, staying on good terms means things don’t get difficult.

That’s just what most people are really thinking.

“Could you check if the patient who collapsed this morning has woken up yet?”

Zhou Can was still a bit worried about that grandmother and her granddaughter.

“Room 0, right? I’ll just call the nurse in that ward for you. What’s the patient’s name?”

Judging by her tone, the triage nurse seemed pretty well connected with the ward nurses.

Every snake has its paths, every mouse its tunnels.

Even the triage nurse at the bottom of the hierarchy has her own little network.

It makes sense that everyone finds their way to survive.

You don’t stick around in a competitive hospital like this for long unless you’ve got some tricks up your sleeve.

“I never actually got the grandmother’s name—just her granddaughter’s. The girl’s called Chen Ziya.”

The grandmother had fainted before Zhou Can could even get a chance to ask.

“No worries! I’ll call their nurse. She’ll be able to check.”

The triage nurse smiled as she pulled out her phone and scrolled through her contacts.

“Thanks! I appreciate it.”

Zhou Can really liked this triage nurse—efficient, friendly, and always gets things done.

“Alright, who’s up next? Come on in!”

Zhou Can looked to the waiting patients in the corridor.

“Me! It’s my turn!”

A woman holding a child stood up and followed Zhou Can into the exam room.

“Please have a seat!”

He motioned for her to sit, his gaze naturally falling to the child in her arms.

Most patients here are children. Occasionally someone brings in a baby a few months old, but families rarely trust a young doctor like Zhou Can—they usually book a senior physician instead.

Only if every other appointment is booked solid do they settle for seeing someone in general outpatient.

The little boy she was holding looked small and thin, his head tucked into his mother’s arms, barely moving.

When Zhou Can noticed the boy’s skin turning purple around his neck and elsewhere, his pupils contracted in alarm.

He’d just been about to sit, but he shot up straight away.

“What brings you in today?”

“He just doesn’t like to move much and barely eats.” The boy’s mother sounded oddly calm about it.

“Has his skin always looked like this?”

The child’s entire body was tinged with cyanic purple. Zhou Can’s gut said the boy was short on oxygen.

But since the mother seemed so calm, clearly it wasn’t a new thing.

“Yes, ever since he was born his skin’s been a bit reddish-purple. As he’s grown, it only got darker. Friends and relatives joke that he’s destined for greatness—a lucky star, born under the sign of Ziwei!”

The woman laughed as she answered.

Zhou Can had to hold back a sigh—so much ignorance and no fear.

With skin this purple, there’s no way that’s a sign of destiny. It’s textbook hypoxia.

“His breathing sounds a bit heavy, doesn’t it?”

Zhou Can could hear the boy gasping each time he inhaled.

That meant he had to work just to get enough air. This, too, pointed to low oxygen.

Think about it—even a healthy person pants after intense exercise since the body suddenly needs more oxygen. Gasping is just the body’s instinct.

“My friends say it’s a sign he’s got amazing lungs! That’s why he breathes like that. Told me he’s a special kid from birth!”

The mother bragged about her son, a little pride sneaking into her voice.

Zhou Can could only shake his head again.

What else could you call this but blind confidence?

She was definitely a textbook case.

Of course, nobody’s going to tell her straight out her child’s sick. People always say nice things. Who would be rude enough to do otherwise?

She took those kind words to heart.

“So, you’re here today because your son doesn’t move much and isn’t eating?”

While measuring the boy’s vital signs, Zhou Can kept asking questions.

“That’s it! Just those two little problems. Doctor, is it because he’s destined for greatness, like those pampered emperors on TV, who never have to lift a finger?”

Her logic truly defied belief.

It was remarkable, honestly.

“Well, it’s possible,” Zhou Can nodded, playing along.

You never argue with someone like her—it would just lead to a fight.

Sometimes it’s wiser to just go with the flow.

A doctor’s job is to cure illnesses, not correct every misguided idea.

The truth is, once adults latch onto an idea, it’s near impossible to change their minds. If you try, all you earn is an enemy.

“So, you think not eating is also a sign of being born to be emperor?”

She had a truly creative way of thinking.

“Why do you say that?” Zhou Can probed.

“Think about it! Emperors eat all those rare gourmet foods every day. Ordinary food holds no interest for them.” Her answer was perfectly serious.

“You’re right. Maybe try giving your son more fine foods like that. Honestly though, he’s far too thin. As doctors, we’d call this malnutrition.”

Zhou Can tried gently steering her with his answer.

She looked around thirty—hard to believe she thought this way. Maybe too many TV dramas were to blame.

After a basic physical exam, Zhou Can found the boy was underdeveloped, suffering from severe malnutrition and cyanosis. His fingertips were clubbed, his breathing wheezy between the ribs, his blood pressure slightly low, and his pulse weak.

This child’s got a serious problem.

“Has he ever had a medical checkup?”

“Once, at a community health clinic. But the young doctor there started making wild claims—said my son might be very sick. I told him off for it! Haven’t taken my son back since. He’s fine—some doctors just like to scare people into buying more medicine.”

Talking about it still made her upset.

Zhou Can wiped sweat from his brow in relief.

Good thing he hadn’t argued with her—otherwise he’d have been the next one she ranted about.

“When I checked your son’s heart rate, I heard a wheezing sound. I’ll write up an order for an echocardiogram. Please take him for a two-dimensional heart ultrasound.”

He addressed the mother directly.

“Alright! Is it serious, Doctor?”

Since the conversation had gone smoothly so far, she agreed right away.

“Hard to say right now. Let’s see if there’s a heart problem first!”

Zhou Can was sure there was trouble here, but after seeing what happened to that doctor at the clinic, he wasn’t about to say it out loud.

Better to wait for the test results.

Once there’s hard data, he’ll have the facts to back him up—no matter what the truth is.

After sending the mother and son on their way, another patient entered the exam room.

“Please have a seat and wait a moment. I need to check on a result for a patient from this morning.”

Zhou Can greeted them, then turned back to the system to find the test results for Chen Ziya.

Tuyu Hospital’s network has gone digital now. Once the lab results are done, patients and their families can print them right from the hospital network using an ID card.

It’s miles easier than digging through stacks of papers at the old windows.

Now admitting doctors can pull up any patient’s results right from the system. Still, most doctors wait for the patient to bring a paper report before checking.

Partly because they’re so busy—there isn’t time to look up every result.

Also, even if a doctor figures out the cause, there’s not much use if the patient isn’t there to talk to in person.

It’s not that doctors are cold or lazy like people think.

Zhou Can soon found Chen Ziya’s name.

Clicking in, he saw the little girl’s bloodwork had finally come back.

Her LDH, CK, AST, and ALT were all elevated—her AST was shockingly high.

“What kind of illness could this be?”

Staring at the lab results, Zhou Can raced through all the diseases he knew.

But no matter how hard he tried, he couldn’t match these symptoms to anything specific.

In this moment, he bitterly regretted not reading more.

Medical knowledge is vast as an ocean—learning it all is impossible. After all, every doctor has limited energy and time.

Learning is a lifelong journey.

He still forces himself to study every day, determined to fill the gaps.

You can’t rush this—it’s all about accumulation, day by day.

That’s why old doctors are so in demand; the best ones never stop learning and collect a lifetime of experience, making them faster and more accurate at diagnoses.

Their chances of missing or misdiagnosing cases are much lower, too.

“Her white cell count and platelets are low; now she has protein in her urine and her AST is sky-high. Could this be poisoning?”

It was definitely a possibility.

Even Chen Ziya’s grandmother had started showing similar symptoms.

If both ate something toxic and got poisoned, it would make sense.

Just then, the triage nurse poked her head back in.

“Dr. Zhou, I checked for you. The grandmother is awake and feeling better. She’s worried about her granddaughter and wants to come see you.”

At least she’s conscious again—that’s good.

“Tell her there’s no need to come right now. I’m still figuring out what’s wrong with her granddaughter. Once I know the cause, I’ll go find her.”

Zhou Can still worried about whether the pair might have an infectious disease.

If it did spread, the consequences would be serious for other patients and families.

Besides, since the little girl’s illness wasn’t clear yet, there was no point in her coming over.

If it really was poisoning, infection could be ruled out.

“But if it’s not poisoning, what else could it be?” Zhou Can wondered, his eyes lighting up.

How could he have missed that possibility?

If not food poisoning, another explanation is a viral infection.

If one of them caught a virus, it could easily be passed to the other.

The more he thought about it, the more sense it made.

Either way, screening for a virus was the safest bet.

A serological test is a quick way to check for viral infection.

He immediately filled out an order for a serology test.

After that, he turned back to the rest of his patients.

Around four-thirty, he glanced at the screen to see if Chen Ziya’s bloodwork was back yet.

Lucky—her results were already in.

Both her IgM and IgG antibodies were positive.

Those readings meant she was almost certainly fighting off a virus.

Usually, when someone catches a pathogen, the body creates specific antibodies—IgM and IgG both come back positive.

Zhou Can felt a jolt of excitement—now he was nearly certain this was a viral infection.

Colds often come from influenza viruses, which count as viral infections too.

But he ruled out the flu quickly—her results just didn’t match up.

A rise in IgM can also be seen in macroglobulinemia or autoimmune liver disease.

A big jump in IgG tends to point to autoimmune diseases.

If both rise together and the other immune proteins drop, it’s likely multiple myeloma.

But Zhou Can stuck to his theory—the most likely thing was a rare viral infection.

If it had been a common virus, he’d have solved the case ages ago.

“Time to check the references!”

When he couldn’t figure out what virus it might be, Zhou Can decided to follow the old-timers’ habits. Like Director Dai, who always brought the pediatric clinical handbook with him when he first started out, sneaking looks whenever he hit a tough case.

This was a particularly tough case—no shame in double-checking the sources.

Thanks to smartphones and the internet, doctors no longer need to lug massive books into the exam room.

Now you just whip out your phone and search online.

Still, some things are easier to find in the medical textbooks.

After searching for a while, Zhou Can found a likely candidate: a rare disease.

The new Bunya virus.

People infected with this virus usually show all sorts of symptoms, including fever and the syndrome of low platelets.

“This has to be it! If I could get a pathogen test, I could confirm the diagnosis for sure.”

He glanced at the clock and restrained his urge to tell the family right away. Instead, he filed a lab request for pathogen testing—the same blood serum, but now they’d try to isolate the new Bunya virus itself.