Chapter 347: Unraveling the Mystery of Abdominal Pain

Cheng Dazhuang stood up and called out, “A’Can, why don’t we go take a look too?”

“Sure!”

Zhou Can agreed, getting to his feet as he instinctively glanced at what book Dr. Luo Jian was reading.

One Hundred and Three Cases of Abdominal Pain in General Surgery.

Judging by the book’s yellowed cover, it was definitely an old one—maybe published forty or fifty years ago.

Doctors love referencing these old case analysis books.

Back then resources were scarce, so most doctors poured over medical studies and treated their work with utmost care. Their case records and notes were precise, making them invaluable for study even today.

But modern times and rapid economic growth have changed things, and now many doctors’ values have become more materialistic.

Plagiarism and copying runs rampant in research papers. Good doctors who are willing to write detailed cases for future generations are rare. Some want to try but worry their skills aren’t enough and fear being criticized, so they hold back.

Zhou Can couldn’t help but smile. Dr. Luo Jian must have run into a tricky patient and was now scrambling for answers, hiding in the office to flip through books for a fresh idea.

It’s the same in every hospital. When doctors hit an unsolvable case—so long as the patient isn’t in critical danger—they’ll try everything on their own first before asking a superior.

This goes double for night shifts.

If you bug your attending with every little thing during a shift, even if they don’t scold you out loud, you’ll definitely leave a bad impression.

Anyone with a bad reputation gets bumped down the list when good opportunities come up.

And worse, that impression means even your smallest mistakes or quirks start looking huge in the chief’s eyes, earning you constant scolding.

So, it’s vital to know your limits and keep a sense of proportion.

Some rookies ask about everything, day or night, even when their supervisors are resting at home—they keep calling at night, then buzz around the chief all day. The worst part is, they think asking a lot will make them seem eager to learn.

Meanwhile, those supervisors have long since blacklisted them in their minds.

They just don’t say it out loud, out of politeness.

“A’Can, hurry up! Let me tell you, this case is complicated and a great learning experience. You picked the perfect day to come.”

Cheng Dazhuang urged him forward, looking genuinely excited.

Turns out he’s not unmotivated, just short on chances to learn.

And with a laid-back work environment, it’s easy to get lazy like everyone else.

As the two approached a ward, they could already hear painful groans from inside.

The room was at least thirty square meters, with just two hospital beds and full amenities. For a county hospital, the inpatient environment was top notch—even better than Tuyu Hospital.

At Tuyu Hospital, it would be unimaginable to have a spacious room like this with only two beds.

The nurse they’d seen earlier at the station was now in the room, anxiously watching the patient clutching his stomach and crying out in pain.

The patient looked about forty, a man with deep lines faintly marking his forehead.

His jaw was clenched in pain, cheeks bulging, and his face twisted in agony.

Zhou Can quietly observed him.

It’s a doctor’s first instinct when receiving a patient. In fact, Western medicine borrowed heavily from the visual diagnostic methods of Chinese medicine.

“The patient was admitted just after five this afternoon for unexplained abdominal pain—and it comes in waves. It’s flaring up again now, I’d say.”

Cheng Dazhuang whispered a quick summary beside him.

Dr. Luo Jian, the attending, was standing at the bedside, examining the patient.

“Is it this spot that hurts?”

He pressed on the patient’s abdomen, asking questions as he went.

“Yes! Ow, ow, ow—this hurts so much!”

Pain twisted the patient’s face, his skin turned pale, and sweat trickled down his forehead.

“Did the pain just start today?”

“Yes, yes! Doctor, please, you’ve got to help me—I can’t take it any longer!”

The patient hissed through his teeth, desperately hoping the doctor could work a miracle and end his suffering.

That’s exactly what nearly all patients hope for.

Once they’re admitted, they think they’re finally saved, putting natural trust in doctors and nurses.

But honestly, sometimes the doctors and nurses are even more nervous than the patient.

If it’s something they know how to treat, no problem. But with mysterious abdominal pain like this, the staff can get even more anxious than the person suffering.

“Take his temperature and blood pressure!”

Dr. Luo Jian frowned, lost in thought, trying to pinpoint the cause of the pain.

Zhou Can stepped up and picked up the patient’s test results and medical records from the bedside.

He’d had an abdominal ultrasound, even a CT, plus full blood work and urine and stool tests. But since the samples were submitted late, the blood test results weren’t back yet.

Everything else looked basically normal—no proteins in the urine, no blood in the stool.

The attending’s likely first guesses were acute appendicitis, cholecystitis, pancreatitis, enteritis, or maybe a stomach ulcer—typical causes of abdominal pain.

Unfortunately, there was no obvious abnormality in all those tests.

“According to your record, you’ve had this stomach pain for more than ten hours? You waited a long time after it started before coming in?”

Zhou Can wasn’t planning to meddle at first.

Otherwise, people might think he’s just showing off.

But when he saw the chief complaint listed as over ten hours of pain, with the patient developing discomfort after working—pain that came in bursts, not all the time—he grew concerned.

After a short rest, the pain would subside.

But not long after, it would return.

This kind of pattern was dangerous and a sign something serious was going on.

“I’ve had stomach pain before, but a trip to the bathroom or some rest usually fixed it. This time it’s different—it comes and goes, and it just keeps getting worse. I really couldn’t stand it anymore, so I came to see a doctor.”

The patient explained, while his wife stood silent at his bedside.

From the looks of it, she didn’t have much say at home.

“Most everyday folks think like you—coming to the hospital means spending money, right? So, is the pain dull or stabbing? Stabbing pain feels like someone’s poking you with needles inside.”

Zhou Can used the chance to chat with him.

“It’s more like a dull ache—really intense, though, and it comes in waves, like someone’s really twisting the flesh inside.”

The patient answered honestly.

“Take a deep breath. I’ll press on your stomach and see if the pain eases up at all.”

Zhou Can instructed the patient to inhale.

But the patient eyed him suspiciously, clearly unsure about trusting such a young doctor.

“He’s from Tuyu Hospital. Just follow his instructions—he won’t steer you wrong,” Cheng Dazhuang said from the side, standing up for his friend.

Dr. Luo Jian kept quiet.

He probably wasn’t too impressed with Zhou Can’s skills either.

“Honey, just listen to the doctor,” the patient’s wife urged.

Only then did the patient cooperate, inhaling while Zhou Can pressed on his stomach.

“Ow—it still hurts like hell! There’s no difference at all! Young doctor, your trick doesn’t work! Doesn’t work!” The patient’s temper flared, much sharper than usual thanks to the pain.

After following Zhou Can’s method with no relief, the patient was noticeably annoyed.

Dr. Luo Jian’s lips curled slightly, probably thinking the hotshot from Tuyu Hospital wasn’t so special after all.

“The appendix is fine, enteritis is pretty much ruled out, no obvious tumors in the abdomen. I suggest we get an ECG or a cardiac ultrasound next,” Zhou Can said, voice serious.

“Doctor, I don’t know much about medicine, but what’s my stomach pain got to do with my heart? Don’t make us waste money on pointless tests,” the patient argued, gritting his teeth.

“Yeah, I’ve never heard of heart problems causing stomach pain,” Dr. Luo Jian added, disagreeing with Zhou Can.

He was basically shooting Zhou Can’s theory down.

But he had no idea just how capable this young trainee from Tuyu Hospital really was.

Back at Tuyu, even the chief physicians often invited Zhou Can to consult on tough cases and participate in major patient discussions.

Cheng Dazhuang was glad Zhou Can had come—more chances to see, learn, and gain hands-on experience.

Truth is, they should feel lucky a talented doctor like Zhou Can showed up in their county hospital.

“Just because Dr. Luo hasn’t heard of it doesn’t mean it doesn’t exist. This case is serious—I suggest an immediate ECG or cardiac ultrasound. Or you could report straight to the chief. Tell them I said the heart may be the root cause here.”

Zhou Can’s tone left no room for argument, grave and firm.

A life was slipping away before his eyes. Out of professional duty, he had to speak out.

“Is it really as serious as you make it sound?”

Dr. Luo Jian looked uneasy, seeing Zhou Can’s serious face.

“A’Can, maybe you and Dr. Luo should discuss this in the office,” Cheng Dazhuang suggested, trying to smooth things over.

With family and patient right there, it was tough to talk freely.

No doctor wants to openly argue in front of a patient.

Even the nurse taking the patient’s blood pressure glared at Zhou Can, clearly annoyed. She thought, what’s so great about coming from Tuyu Hospital? He’s so young, probably just an intern or trainee. How dare he speak to Dr. Luo that way?

Completely out of line.

“If you doubt my diagnosis, there’s a simple solution: just compare the blood pressure on the patient’s left and right arms,” Zhou Can said.

Ignoring the nurse’s hostile glare and Dr. Luo’s dark look, he focused on getting the patient the care he needed as quickly as possible.

“This nurse already measured the left arm. Just check the right and we’ll have an answer,” he said.

“In my four years of nursing, the blood pressure is always the same on both arms. There’s no need to measure both,” the nurse insisted.

She wasn’t convinced in the slightest.

And that was normal, of course. Hospital staff band together when an outsider comes in, naturally siding with their own.

“Measuring the right arm won’t take long, and maybe you’ll learn something new from this clinical experience,” Zhou Can said calmly.

Given his skills and experience, he couldn’t be bothered to argue with a nurse.

“Tutu, just measure the right arm. Let’s see if Tuyu Hospital’s doctors really are something special!”

Dr. Luo Jian finally spoke, and the nurse turned to measure the right arm’s blood pressure.

Everyone quietly watched, waiting for her to finish.

As she watched the numbers, the cold-faced nurse started to look surprised.

Shock and disbelief spread across her face.

“Tutu, what’s the reading?”

Dr. Luo Jian noticed the shift and felt a surge of unease.

But what worried him more was the actual danger to the patient.

If Zhou Can was right—and this patient had been in pain for over ten hours—his life could be in real jeopardy.

Normally, chest pain that lasts more than forty minutes is an immediate red flag.

That’s why chest pain patients skip lines and head straight to the Chest Pain Center and emergency green zone. Once it’s a heart issue, things can turn fatal, fast.

“He was right…there’s a difference of nearly thirty points between the arms. This is incredible—I’ve never seen anything like it before.”

The nurse’s face flushed hot.

She was mostly shocked, but there was also a tinge of shame and maybe even a little inferiority.

She hadn’t realized just how big the gap was between her and a doctor from Tuyu Hospital.

It turned out she’d been seeing the world through a keyhole.

“He needs an emergency ultrasound right away. My only worry is we might have caught this too late—even with rescue efforts, there may not be a chance,” Zhou Can urged.

He’d rotated through the emergency, cardiothoracic, and critical care departments at Tuyu Hospital.

His experience far outstripped that of most county physicians and nurses. He’d seen too many patients who were fine one moment, only to crash and die despite frantic rescue attempts.

“Move him to emergency now! Call Director Wang from Cardiothoracic Surgery, and get Nurse Supervisor Liu Bin over here! Cheng Dazhuang, help transfer the patient for resuscitation immediately!”

Dr. Luo Jian was already scrambling to unlock the bed and push it toward the Emergency Department.

You don’t become an attending by accident—you need some real experience.

Once he saw Zhou Can was right, he didn’t hesitate. He snapped to high alert.

“Doctor, my husband only has stomach pain—is it really that dangerous?” The family wasn’t ready to accept it. They even doubted the hospital.

“It looks like a stomachache, but it’s actually a problem with his heart. You’ll see when the test results come back. In my experience, if the heart’s involved, things look grim. Go with them—you’ll have lots of consent forms to sign, and there’s no time to waste.”

That was all Zhou Can could say.

He couldn’t flat out tell the family, ‘Your husband’s in critical condition and might not make it,’—that’d be foolish.

He didn’t want to get punched by the family.

Zhou Can stayed behind. He was just a guest here to catch up with an old friend.

Joining in the county hospital’s emergency care would be inappropriate.

Unless they specifically invited him, of course.

Otherwise, he’d just look like he was showing off and meddling.

Nor did he return to the office—no one was there, and lingering as an outsider would be even more awkward.

Sometimes you really have to watch your step.

Knowing when to stand back is part of self-discipline.

The hallway lights were dim, only the nurse station glowed brightly. Zhou Can sat on a row of chairs and checked his phone for messages.

“Um… Dr. Zhou, could you help with first aid for that patient from earlier?”

Not even half an hour had passed when a nurse came running over, face full of anxiety.