Chapter 441: Under the White Coat: A Day in Pediatrics

“Let the nurse call patients in order, just like always.”

After Zhou Can said this he ignored the woman completely and walked straight into the exam room.

The triage nurse was Zhou Yanqing, an old friend of Zhou Can’s.

They’d worked together for ages—a single look from Zhou Can and she knew exactly what he needed.

“Number one, Tang Juxiang!”

“That’s us, that’s us!”

A young woman sitting on the bench quickly scooped up her child and hurried into Clinic Room 17.

Now, not a single family member spoke up for that woman who’d just been yelling. People might not say it out loud, but everyone has their own internal scale. Right and wrong don’t escape their eyes, even if they don’t voice it.

People’s sympathy can’t be exploited so easily.

“Dr. Zhou, please take a look. My child won’t nurse all of a sudden and I just don’t know why.”

The woman’s husband and family hadn’t come with her.

Judging by her clothes, she was clearly well off.

“The baby looks so tiny—just born, right?”

Zhou Can started checking the baby.

He immediately noticed the infant was incredibly pale, lips tinged with blue, breathing irregular. These were classic signs of newborn jaundice, a condition that’s all too common.

“He’s exactly twenty-one days old today, not even a month. He started refusing to nurse just yesterday and has been incredibly fussy, always crying, throwing tantrums.”

The mother described the baby’s symptoms as she held him.

“Are you breastfeeding or giving formula?”

“Only breastfeeding. From birth till now, always mother’s milk. I worried my supply wouldn’t be enough at first, so I hired a maternity nanny—she seemed professional enough, made me all sorts of food like pork trotter soup, rice wine eggs. My milk kept increasing, sometimes even more than the baby needed so I’d feel swollen. But since yesterday morning he’s just started resisting breastfeeding. The nanny told me to hurry up and take him to the hospital.”

She gazed down at the baby in her arms, radiating the gentle glow of a loving mother.

A mother’s love begins the moment she learns she’s pregnant. After ten months of carrying the child, if anything, her burden only gets heavier—there are endless nights soothing cries, nursing, and cleaning up after the baby.

Hiring a maternity nanny spoke volumes about her financial standing.

These days, getting a maternity nanny will cost you at least five thousand. Anyone claiming to be ‘top-tier’ easily charges over ten thousand.

“So you and the nanny are taking care of the baby together?”

“That’s right!”

“Are your family helping out? Like your parents, mother-in-law, or husband?”

“Why do you need to know that? Doesn’t seem related to his illness.”

She dodged the question, unwilling to answer.

“Don’t get me wrong, I’m just trying to rule out any issues in the child’s care.” Since she didn’t want to answer, Zhou Can didn’t push further.

Some women these days have children while being the ‘other woman.’

Illegitimate children have to stay hidden, so the father’s identity is often tightly guarded.

“Your baby seems unusually lethargic. Even if he hadn’t eaten for a whole day, it shouldn’t be like this. Did you give him water?” Zhou Can asked.

“Yes, but he barely drank any.”

“When breastfeeding, is his suckling still strong?”

“Much weaker than normal, no strength at all.”

“Any bowel movements? Any diarrhea?”

“Diarrhea, actually. Ever since the third day after birth he’s had diarrhea. The nanny said it’s normal and it’ll stop once he gets bigger and his digestion improves.”

“How about his sleep?”

“He wakes up at the slightest thing, always crying, especially at night. Last night, he made a fuss every few hours, kicking and punching, crying so hard. Nothing I did could calm him down.”

“Was he always like this before?”

“No, just since two nights ago. And even then, two nights ago wasn’t so bad.”

…

After asking about the baby’s basic condition and history, Zhou Can took his temperature. It was normal.

But when he checked the baby’s abdomen, it was unmistakably hard.

That meant obvious abdominal swelling.

“We need to run two tests. If the baby passes urine or stool, collect some for lab samples. For now, let’s run the three basic tests first—once you have the results, come back for a further diagnosis.”

Zhou Can quickly filled out the test requisitions.

These three standard tests were basically mandatory in situations like this.

“Dr. Zhou, my friends said you’re a great doctor, highly ethical and responsible—that’s why I insisted on seeing you. Is my son seriously ill? Could it just be something minor, like catching a chill at night?”

Naturally, she was hoping to build rapport with Zhou Can.

“Hmm… hard to say just yet. But judging by your baby’s symptoms, it doesn’t look too good, so please don’t wait. You really should’ve come in yesterday as soon as he started acting differently. Infants aren’t like adults—their illness can progress very quickly, and they’re so much weaker. Their systems aren’t fully developed and they’re much more fragile.”

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Normally, Zhou Can didn’t like to talk in such serious terms.

But seeing how this young mother seemed fairly unconcerned, he had no choice but to warn her.

“He’ll be alright, right? What should I do if something’s wrong? I was debating coming yesterday—it’s all my fault. What do I do now?” She started to panic.

“Go get the tests done—you’re first in line, so the blood test results should be out in a couple hours at most. If it’s just neonatal jaundice, it’s fairly treatable. I’m mostly concerned about sepsis, which is much more serious. So make sure to bring the baby back immediately with your results—don’t delay. Also, aside from breastfeeding and a little water, don’t give him any other food right now.”

Based on his experience, Zhou Can strongly suspected the baby had neonatal sepsis.

This illness is most common in babies between three days and two weeks old.

Since this child got sick after twenty-one days, his resistance must’ve been decent. Or maybe he fell ill days ago, but his mother didn’t realize.

Neonatal sepsis is a full-body infection caused when bacteria enter the bloodstream.

Because newborns’ nervous systems aren’t fully developed, their bodies react weakly; their skin, mucous membranes, and digestive tracts have poor defenses, and their lymph nodes can’t contain the infection. Instead of staying localized, it spreads rapidly.

In no time, it can turn into full-blown sepsis.

Right now the baby was in poor shape and hadn’t eaten for a day and a night—Zhou Can felt truly anxious.

Up against a disease like this, a tiny life can slip away so easily.

The young mother rushed off for the tests with her child, just as Zhou Can had instructed.

He almost wanted to ask why the baby’s father hadn’t come.

After all, the mother had given birth just twenty-one days ago and was still recovering. Carrying the baby around everywhere was tough on her body and could cause lasting problems—what people call ‘postpartum complications.’

In Huaxia, it’s a long-standing tradition for new mothers to take time to rest after giving birth.

It’s not about being delicate—it’s ancient medical wisdom, and a core part of traditional medicine.

Women abroad don’t have these customs.

They tend to believe rest after childbirth isn’t necessary. They’ll bathe right away, eat and drink whatever they want, even give birth in water. To each their own.

Right after giving birth, mothers’ energy and blood are at their lowest. Even if foreign women and women from Huaxia have different immune systems, pushing your body too soon can cause complications that last a lifetime.

Only those who’ve gone through it know just how much pain and hardship it can bring.

Patients came in one after another. Zhou Can worked fast, but when tricky cases appeared, he’d slow down and analyze everything carefully—even consulting with experts in Pediatrics for complicated diagnoses.

Overall, his recovery and improvement rate stayed high—whether for common illnesses or stubborn ailments, his results were always among the best.

He’d been seeing outpatients in Pediatrics for nearly two years. In his first year, his CMI score reached 3.2.

Keep in mind, even chief physicians in Pediatrics usually have a CMI of only 1.5 or so.

Of course, some outstanding doctors can hit 6.0 or higher.

CMI stands for case mix index, internationally recognized as a measure of technical difficulty in treating cases and the hospital’s ability to handle complex or critical illnesses. The higher your CMI, the more difficult and severe your cases.

It’s even linked directly to how much advance insurance funding the hospital can get.

In China, there’s now growing focus on CMI scores since they reflect a doctor’s actual skill.

If all your cases are simple, your CMI will naturally be low.

This year’s CMI wasn’t released yet, but Zhou Can estimated he’d easily top 4.0.

That’s still with him working as an assistant on major surgeries. If he led the surgeries himself, or handled more difficult consultations as the lead, his CMI would be through the roof.

Skill-wise, he likely matched the best doctors in his hospital.

Of course, this didn’t mean he’d reached the top yet—just that objectively, he was doing exceptionally well.

There was still plenty of room for him to grow, whether academically or clinically.

Even the top directors and specialists would say medicine has no end. The more you learn, the more you realize how vast it all is.

Human understanding of the body is still only skin-deep at best.

Soon, the woman whose child’s left arm was broken came in too.

Because Zhou Can hadn’t let her cut in line for urgent care, she was clearly a little hostile.

Once inside, she switched to looking pitiful.

“Dr. Zhou, my family’s really struggling. We have three kids. You’re so skilled and kind—could you please help us save on our child’s treatment costs?”

As she talked, she even managed to squeeze out a couple of tears, wiping them away sadly.

If a rookie doctor saw this, chances are they’d be overwhelmed with sympathy and do anything to meet her requests.

Especially in Pediatrics, where most doctors are women.

Women doctors tend to be even more soft-hearted.

“Raising three kids is definitely no easy feat. Don’t worry, I’ll do everything I can to help you save where possible.”

By now, Zhou Can was something of an old hand.

His responses left no openings for criticism.

He was used to dealing with all sorts of difficult families.

Of course, if someone really started pulling wild stunts—crying, making a scene, or even threatening self-harm—sometimes he couldn’t hold them off either.

Luckily, Pediatrics chief Tang Fei had a strong relationship with the hospital’s Security Department.

Several times when rogue family members came to cause trouble, Security would step in right away and take control.

It’s important to note, hospital security are hired employees—not police. They have no real authority to enforce laws.

But in a dangerous situation, they can still restrain people.

That’s why they’re called ‘security’—their main job is to keep the peace in the hospital. Within these walls, they have plenty of leeway. If a family member waves a knife and threatens lives, the best security staff are sent in.

These guys form what’s basically the riot squad.

Armed with steel forks, shields, and electric batons, they don’t hesitate to subdue attackers.

In those moments, as long as they avoid deadly force, they won’t hold back.

But there’s another thing—if any department or doctor ever offends Security’s boss, when trouble starts, their team may wait until the doctor or nurse gets hurt before showing up.

Sometimes, even if they arrive on time, they’ll stand back and just watch.

The hospital world is deeper and more complicated than it seems.

It’s best not to offend the support staff. Many of them have connections, and you never know who has powerful backing.

For example, Zhou Can once overheard a colleague complain that most of the hospital’s permanent positions ended up going to support staff or connected hires.

He hadn’t understood why, since support staff usually didn’t have high education or much to offer.

How could they land those coveted, limited positions?

Later, when he found out, his eyes were opened.

There was this unemployed guy—people called him a street punk—with a beautiful sister. One day, some rich young man took a liking to her, and the two started dating.

Soon, the sister revealed that her boyfriend was the son of the deputy director of a certain hospital.

Hearing this, the brother’s mind whirred into action.

He’d been drifting aimlessly, barely making ends meet. But big hospitals rake in millions every day. If he landed a job there, it would be like picking up money off the ground.

So he begged his sister to help him get in.

She saw he was going nowhere with his crowd, and their parents couldn’t control him. He was already in his thirties and still single—helping him get a real job seemed like a good idea.

It would give their parents one less thing to worry about.

The deputy director’s son was head-over-heels about her, so she brought it up.

To win her over, the boyfriend agreed right away.

Finding the future brother-in-law a hospital job—that was no problem.

He simply went to his dad, the deputy director.

Based on his background, the guy wasn’t anything special—no education, no skill, not even any motivation.

Hospitals these days hire college grads as a minimum.

And if you want to be a doctor, you need at least a master’s degree.

How could this ‘triple threat’ (no education, no skill, no ambition) land a job at such a prestigious place?

But for the deputy director, this was easy.

He first hired the guy as outsourced staff in the Security Department. After two years, he made him an official employee through an HR loophole.

Finally, he even passed on one of the most sought-after lifetime positions.

With this series of moves, a street punk became a formal hospital employee, snagging a job that even PhDs would fight over.

Imagine: a guy who never finished elementary school lands a permanent job, while doctors working their fingers to the bone for twenty years can’t even get a spot. Isn’t that just plain sad?

Though this kind of thing is only an occasional case at Tuyu Hospital, it’s common across most hospitals.