Chapter Index

    The patient wasn’t old, just in his mid-thirties. If something went terribly wrong, it would be a devastating blow to his family.

    Raising a son to this age is no small feat for any household.

    At thirty-four or thirty-five, he’s likely just starting to take over the family responsibilities from his father, with a career on the rise and a young family of his own. Imagine the chaos if he were to collapse now—the impact on their lives would be unimaginable.

    Why is the mortality rate for acute pancreatitis so high?

    First, let’s address a key issue: why does it cause low blood pressure?

    The primary reason for the drop in blood pressure is the secretion of substances like bradykinin.

    Bradykinin dilates blood vessels, increasing vascular capacity and leading to low blood pressure. Patients often experience intense thirst and cold limbs as a result.

    If it were just low blood pressure, it wouldn’t necessarily be fatal.

    The real killers are complications like organ failure, systemic inflammatory response, severe abdominal infections, and gastrointestinal bleeding. Bradykinin secretion is a trigger for these deadly issues.

    The pancreas is a remarkable organ—it can literally ‘eat’ itself.

    Once the pancreatic enzymes are activated, a horrifying process begins: the pancreas starts digesting its own tissue, eventually leading to bleeding or even necrosis.

    As the body’s second-largest digestive organ, how does it consume itself?

    Normally, the pancreas secretes insulin to regulate blood sugar, utilizing glucose from food and maintaining the body’s metabolism. It also produces pancreatic juice, which helps break down greasy foods and clear out dietary fats.

    It’s truly a hardworking digestive organ.

    Pancreatic juice is initially secreted as inactive enzymes, only becoming active upon contact with stomach acid and protein-rich food.

    Those with acute pancreatitis are highly prone to gallstones.

    Once gallstones form, they can fall into the junction of the pancreatic duct and gallbladder, blocking the outlet. This causes bile to flow into the pancreatic duct or pancreatic juice to backflow. At that point, the inactive enzymes are activated, and they begin digesting the pancreas itself.

    That’s the entire process of the pancreas ‘eating’ itself.

    Among the family members was a younger man who bore a striking resemblance to the patient. In his twenties, he might be the patient’s younger brother.

    After hearing Zhou Can’s diagnosis, he still seemed uneasy. “Doctor, are you sure about your diagnosis? What if my brother’s condition isn’t acute pancreatitis? Could it delay critical treatment?”

    “Please don’t take offense! It’s just that you seem so young, and with a life on the line, we came to Tuyu for safety.”

    The family’s main concern was Zhou Can’s youth and perceived lack of experience, fearing he might miss the critical window for treatment.

    “No doctor can guarantee absolute certainty. If you don’t trust my diagnosis, I can’t force you. We can arrange for another doctor to take over.”

    Zhou Can would be lying if he said he wasn’t irritated by their doubts.

    In his experience, once a family starts questioning a doctor, endless complications follow.

    It becomes a major hindrance to treatment.

    Every medication prescribed prompts a barrage of questions: What’s this drug for? Is it effective? What if it doesn’t work? Are there better alternatives?

    The endless doubts could drive any attending doctor up the wall.

    Truthfully, Zhou Can didn’t even need to handle triage desk duties. He only stepped in when the on-duty doctor couldn’t manage, helping out as needed.

    After all, saving lives was the top priority.

    Moreover, Director Lou, Deputy Director Han, and others had repeatedly authorized Zhou Can during department meetings or public settings to take charge of emergency rescues when necessary.

    Rescues often happen in a very short window of time.

    If they weren’t on-site, someone with high expertise had to lead the rescue effort.

    Without a doubt, Zhou Can’s skills stood out among the emergency doctors. In the entire Emergency Department, only a handful like Director Lou, Deputy Director Han, and Dr. Xu could match his caliber.

    Nowadays, Zhou Can’s rescue capabilities might just make him the top expert in the Emergency Department.

    At that moment, Deputy Director Han rushed over from the ICU.

    The emergency ICU usually had two highly skilled chief and associate chief physicians rotating shifts. Only in extremely critical cases would they call in other top doctors from the Emergency Department to assist.

    Sometimes, they had to maintain a patient’s breathing, heartbeat, and blood pressure all at once—a single doctor often couldn’t handle it alone.

    Additionally, operating advanced rescue equipment like extracorporeal membrane oxygenation required multiple doctors and nurses working together with precision and skill.

    “Director Han, you’re just in time! The family has some doubts about Dr. Zhou’s diagnosis. Could you take another look at the patient?”

    Dr. Xie, the initial attending doctor, was most worried about the patient passing away.

    Now that Zhou Can had finally reached a diagnosis, the family’s reluctance to cooperate was frustrating.

    Families often trusted older doctors, and Deputy Director Han certainly fit the bill.

    “What’s Dr. Zhou’s diagnosis?”

    Deputy Director Han glanced at the family before turning to Zhou Can.

    “I strongly suspect the patient has acute pancreatitis. I’ve ordered a blood panel, fasting blood sugar test, and an abdominal ultrasound. The family thinks I’m too young and would feel more at ease if an older doctor could confirm the diagnosis.”

    Zhou Can spoke tactfully in front of the family, keeping any negative emotions out of his tone.

    In an era of heightened tension between doctors and patients, medical staff had to adapt to this challenging environment. They needed to refine communication skills, standardize procedures, and avoid conflicts with families or patients.

    “Director, please take another look at my son!”

    The family promptly appealed to Deputy Director Han.

    “What’s there to check again? In terms of skill, Dr. Zhou is no less competent than me. Having me re-diagnose is just a waste of precious rescue time. Hurry and get the tests done! Saving a life comes first.”

    Deputy Director Han urged the family with a firm tone.

    Though still somewhat skeptical, the family didn’t object further.

    The patient was sent for testing.

    “Director Han, I’ll leave this patient in your hands. I need to head to the operating room.”

    “Go ahead, get to it!”

    Ever since the incident when a family member broke Deputy Director Han’s hand, Zhou Can had stepped in to pull strings for a swift surgery and a better ward. Han had been grateful to Zhou Can ever since.

    At work, he took extra care to support Zhou Can in every way.

    Sow kindness, reap kindness.

    Many of Zhou Can’s connections came from helping others in times of need.

    Around 9 a.m., news came in confirming that the patient suspected of an aortic dissection rupture was indeed suffering from acute pancreatitis. The condition was dire, and Gastrointestinal Surgery had already taken over the case.

    For such critically ill patients, Emergency Department doctors always tried to transfer them to specialized departments.

    Otherwise, if anything went wrong, it would only lead to endless trouble.

    “I didn’t expect it to actually be acute pancreatitis. At first, I thought an aortic dissection was more likely. Zhou Can, you’re truly impressive. Not only are your surgical skills exceptional, but your diagnostic abilities are top-notch too.”

    Jiang Wei gazed at Zhou Can with admiration.

    Getting someone as talented as her to express such respect was no easy feat.

    “Diagnosing it isn’t anything special. With a keen eye and deep knowledge of pathology, plus plenty of clinical experience, you could do the same.”

    Zhou Can didn’t think much of it.

    The operating room was especially busy that day, with surgical patients lining up one after another.

    It wasn’t until around 12:40 p.m. that Zhou Can finally led his surgical team to the cafeteria for lunch. Normally, they ate there. Only if they missed the meal window would they order takeout and eat in the break room.

    As soon as he stepped out of the operating room, Zhou Can spotted a young man striding toward him.

    It was none other than the younger brother of the acute pancreatitis patient.

    Zhou Can instinctively grew wary. What did this guy want? Could it be that something happened to his brother, and he was blaming Zhou Can for it?

    “Boss, should we call security over?”

    Yang Zhi whispered cautiously.

    Seeing a family member approach quickly with a long, wrapped object in hand, everyone couldn’t help but feel on edge.

    “Not yet. You all go eat first.”

    Zhou Can had confidence in his abilities. Even if that long package contained a sharp knife, he was sure he could handle it.

    Disarming an opponent bare-handed was a skill most combat experts mastered.

    “Dr. Zhou, this is for you!”

    The young man quickly unwrapped the package, revealing a thank-you banner inside.

    Everyone let out a small sigh of relief.

    If you’re giving a thank-you banner, just say so—why make it so nerve-wracking?

    “What’s this about?”

    Zhou Can was a bit puzzled. Was this guy just handing out banners without explanation?

    He’d already received more thank-you banners than he could count.

    “It’s to thank you for saving my brother! The doctors in Gastrointestinal Surgery told us that if he’d been brought in any later, the consequences could have been dire. They also said his symptoms were very similar to an aortic dissection, making it incredibly hard to diagnose. It was your accurate diagnosis that bought crucial time for his treatment. And yet, I doubted your expertise. I’m truly sorry, and I sincerely apologize.”

    After the young man’s explanation, Zhou Can finally understood the situation.

    The patient’s condition had indeed been critical. Zhou Can’s contribution wasn’t the biggest, but it was pivotal.

    Without his timely and correct diagnosis, the patient might not have made it.

    “How’s your brother doing now?”

    Zhou Can asked casually as he accepted the banner.

    “After the surgery, he’s doing much better. He’s recovering in the ward now.”

    “Glad to hear he’s okay.”

    Zhou Can nodded with a smile.

    Every time he heard news of a patient pulling through, a wave of joy washed over him.

    His sense of accomplishment was overwhelming.

    “I can’t accept a reward I haven’t earned. I didn’t do much—this banner would be better given to the chief surgeon.”

    Zhou Can refused to take the thank-you banner from the family.

    “We need to thank the chief surgeon, but we must thank you even more. These banners are custom-made. Please don’t refuse—it’s just a small token of our gratitude.”

    “Alright then. Thank you, thank you!”

    Zhou Can accepted the banner.

    Heading to the cafeteria for lunch went without saying.

    While eating, he habitually checked his phone, replying to important messages one by one.

    He knew this eating habit wasn’t healthy, but he had no choice. His time was just too tight.

    Director Xueyan had sent him several messages in a row.

    Opening them, he learned that Cardiothoracic Surgery had received a very special patient. Only seventeen years old, suffering from heart failure, the patient had come from the Imperial Capital specifically to seek treatment from Dr. Zhou Can.

    Cases like this were often extremely challenging to treat.

    The Imperial Capital was home to countless major hospitals with the best medical expertise in China. Most of the country’s top medical experts and professors were concentrated there.

    “After lunch, I need to head to Cardiothoracic Surgery. Yang Zhi, take the team and handle some minor surgeries for now.”

    Zhou Can’s team had recently grown by one member, and the pressure had noticeably increased.

    They needed to push harder and perform more surgeries to earn enough. Otherwise, supporting a top-tier nurse like Jiang Wei would be tough.

    Was her salary particularly high?

    Not really, it was average.

    But it definitely added to the revenue pressure on the Emergency Department Operating Room. For Zhou Can’s team specifically, it meant he needed to complete at least forty additional level-three surgeries or over four hundred level-one or two surgeries each month.

    With him stepping away temporarily, Yang Zhi and the others had to step up.

    Otherwise, Director Lou would be having a ‘chat’ with him after hours.

    “Boss Zhou, can I come with you?”

    Jiang Wei asked eagerly, her eyes lighting up.

    “I’m afraid not. Qiao Yu is off today, and you’re our team’s instrument nurse. If you come with me to Cardiothoracic Surgery, Yang Zhi and the others won’t be able to operate. There’ll be other chances—don’t worry.”

    Zhou Can noticed how keen Jiang Wei was to go to Cardiothoracic Surgery.

    Why was she so eager? To broaden her horizons? To take part in a major surgery? It left Zhou Can a bit puzzled.

    Logically, she’d interned at top hospitals abroad. What kind of scene hadn’t she witnessed?

    Broadening her horizons didn’t quite add up.

    Participating in a major surgery wasn’t likely either, at least not yet. Of course, if Zhou Can vouched for her and let her assist as a surgical nurse during a level-four surgery in Cardiothoracic Surgery, she could get involved.

    The problem was, Zhou Can wouldn’t agree to it.

    Even now, he still harbored a guarded heart toward this woman.

    “Alright then. I just wanted to come along and help. A patient from the Imperial Capital must be an extremely challenging case. I thought I might be of some use.”

    She seemed a bit disappointed, offering a rare explanation.

    “I appreciate your good intentions, thank you. There’ll be opportunities in the future. Once our surgical team grows stronger and takes on various major surgeries, I’ll definitely need your help.”

    Zhou Can reassured her.

    After lunch, he hurried to Cardiothoracic Surgery without bringing Jiang Wei along.

    Unlike most people who easily softened, Zhou Can was resolute in his decisions. When it was time to be firm, he never wavered.

    Otherwise, he’d only be setting himself up for trouble.

    Upon arriving at Cardiothoracic Surgery, Director Xueyan was resting in her office. She brightened up at the sight of him and immediately led him down the corridor to meet the heart failure patient.

    The patient had arrived that morning. Even coming from the Imperial Capital, without exceptional connections or backdoor access, they’d likely have to wait in the corridor or outside the office in the waiting area, just like any ordinary patient.

    “Sis Yan, have any tests been done on the patient yet?”

    “Just a blood test so far. The rest is up to you to decide. The patient has already undergone nearly every possible test at Renhe Hospital in the Imperial Capital. Unfortunately, they still couldn’t pinpoint the cause.”

    Tests within their validity period generally didn’t need to be repeated.

    Chapter Summary

    Zhou Can diagnoses a critical case of acute pancreatitis, facing skepticism from the patient’s family due to his youth. Despite doubts, his diagnosis proves correct, earning him a thank-you banner from the patient’s brother. Deputy Director Han supports Zhou Can’s expertise, reinforcing his standing. Meanwhile, a busy day in the operating room continues, and Zhou Can learns of a special heart failure case in Cardiothoracic Surgery from the Imperial Capital. He remains cautious of Jiang Wei’s intentions, balancing team dynamics and high-stakes medical challenges.
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