Chapter 552: Level Six Pharmacological Reasoning: The Trouble with a Child’s Cooling Patch

“His cries sound so hoarse. A dry throat from dehydration is no small matter.”

Zhou Can frowned slightly before turning to the nurse.

“Do we have any clean straws? The kind with a balloon tip.”

“Yes, we do!”

“Could you grab one for me? I want to give this little baby some water. It’s heartbreaking to see him like this.”

He gently patted the infant’s back, trying to soothe him.

Once the nurse brought the straw, he had her help open a bottle of water. Carefully, he drew a few drops into the straw and squeezed them into the baby’s mouth.

His movements were tender and precise.

The infant licked the water off his lips, his cries fading. He gazed up at Zhou Can with longing eyes, as if pleading, ‘Uncle, just a little more.’

“I never thought of feeding him water this way! I tried using a small spoon before, but he choked and started wailing. I didn’t dare try again after that.”

The new mother watched Zhou Can effortlessly give water to her child. Not only did the baby avoid choking, but he seemed to enjoy it.

Her trust in Zhou Can’s skills soared in that moment.

Even the family members looked at Zhou Can differently now, their eyes filled with respect and confidence in his abilities.

“Using a spoon to feed water works better for slightly older babies, around six months. At that age, they’re less likely to choke. But be careful—if a baby chokes too often while drinking, it can lead to issues like pneumonia. That’s something to watch out for.”

Zhou Can wasn’t just trying to scare the family.

Newborns’ lungs aren’t fully developed since they relied on the umbilical cord for breathing in the womb.

On the other hand, crying isn’t always a bad thing for infants. It helps exercise their lungs, aiding them in adapting to the outside world.

Especially for newborns, if they don’t cry or make noise after birth, midwives get worried.

They’ll do everything to make the baby cry, like tapping the soles of their feet. Of course, they try not to let the family see this to avoid misunderstandings.

“Was it a natural birth or a C-section?”

“Natural birth!”

“Since the baby can drink water, you could try the same method with breast milk. It’s packed with nutrients and special elements that boost immunity. If he won’t latch, you can express the milk into a bottle and use the straw to feed him little by little. Just don’t draw too much at once to prevent choking. If he chokes a couple of times and feels uncomfortable, he might start rejecting this way of feeding.”

Zhou Can patiently explained the feeding techniques to the new mother.

Right now, the priority was getting the baby to take some milk to maintain immunity and nutrition.

“Got it. I’ll try that in a bit.”

With so many people around, the mother couldn’t express milk right then. But once she learned the method, she could manage on her own after the doctors left.

Zhou Can continued to give the baby a little more water.

The child’s expression softened, looking far more comfortable and natural. The furrowed little brow had smoothed out considerably.

Both the family and the mother watched this unfold, their hearts swelling with relief.

After so many days of the baby refusing to eat, their worries had been mounting. Now, they finally felt a bit of ease.

“I need to run some physical exams on the baby. I’ll have to place him in the crib for that.”

Zhou Can informed the family.

“That’s fine.”

The family and the mother readily agreed.

At this point, in their eyes and hearts, Zhou Can was the ultimate expert. They were more than willing to let him examine and treat their child.

Zhou Can first checked the baby’s neck pulse. It felt very faint.

In patients with heart failure, the pulse is often weak like this.

Next, he conducted a thorough full-body examination, including listening to the heart and lung sounds with a stethoscope.

During the auscultation, he noticed a murmur in the left chest.

After careful analysis, he determined the murmur originated from the upper-middle area along the left edge of the sternum.

The sound was rhythmic, occurring only during heart contractions.

Ordinary doctors might struggle to distinguish whether a heart sound happens during contraction or relaxation, but someone at Zhou Can’s level could pinpoint it with precision.

“The X-ray results show an enlarged heart and increased pulmonary vascular markings, some even indicating pulmonary venous congestion. Additionally, the ECG suggests a right-axis deviation and right ventricular hypertrophy. So, I strongly suspect there’s an issue with the aorta.”

Several senior doctors were present, including Director Le from Cardiothoracic Surgery.

Since Zhou Can had reached a preliminary diagnosis, there was no need to hold back. He shared his thoughts openly for discussion.

The only thing to be mindful of during ward discussions was showing respect to senior doctors.

You couldn’t contradict them in a way that made them lose face.

For instance, if a senior doctor just stated in front of everyone that the issue might be with the left ventricle, and you immediately counter with the right ventricle, it’s essentially challenging them publicly.

That would put the senior doctor in an awkward position.

“Director Le, what’s your opinion?”

Dr. Tang Fei, less experienced with cardiac surgical diseases, turned to Director Le for his input.

“Zhou Can’s suspicion has merit. We can confirm it with an echocardiogram.”

Director Le’s diagnostic skills weren’t low, but in many areas, Zhou Can had already surpassed him. He rarely opposed Zhou Can’s opinions. Out of the few times he did, only once did he avoid being proven wrong.

And that was a long time ago.

Now, Zhou Can’s skills in both diagnosis and surgery far outstripped his own. Director Le wouldn’t dare lightly contest Zhou Can’s conclusions.

Performing an echocardiogram would indeed be very helpful in diagnosing aortic issues.

Given the child’s critical condition, an echocardiogram was arranged on the spot.

The results revealed aortic valve stenosis, with a significantly long narrowed segment. The blood flow signal in that area was poor.

“It’s highly likely to be a coarctation of the aorta.”

Zhou Can stated after reviewing the results.

“We can basically confirm that a narrowed section of the aorta is causing severely reduced blood flow,” Director Le agreed with Zhou Can’s assessment.

“The baby is only three days old. If possible, I think we should avoid surgery for now. We can start with medical treatment to manage the heart failure and consider surgery at a later date based on his condition.”

With his diagnostic opinion supported, Zhou Can offered further treatment suggestions.

Director Le, despite his refined and elegant demeanor, was a decisive force when it came to treatment plans—a true thunderbolt in decision-making.

For a newborn’s treatment plan, it was better to let Zhou Can take the lead.

“What medical approach are you planning to use, Dr. Zhou?” Dr. Tang Fei also believed medical treatment was safer for a newborn.

“Prostaglandin E1 to open the arterial duct is a solid option. It can effectively reduce the child’s hypoxia.”

After careful consideration, Zhou Can provided his answer.

[Pharmacological Reasoning Experience +1, Bonus Experience +10.]

[Congratulations! Your Pharmacological Reasoning has advanced to Level Six. Current Experience: 1/1,000,000, Junior Chief Physician Level.]

His Pharmacological Reasoning had long been on the verge of leveling up.

This medical skill was incredibly important, yet its progression was slower compared to other skills. It lagged even behind Pathology Diagnosis in terms of upgrade speed. Now that it had finally reached the Chief Physician level, Zhou Can had patched up a significant weakness.

The days of being outdone by his subordinate nurse, Jiang Wei, were over.

With both Pharmacology and Pathology at Level Six, his clinical expertise had undeniably reached Chief Physician standards.

Whether it was outpatient consultations, surgeries, ward rounds, or rescuing critical patients, this upgrade would provide immense support to Zhou Can.

He quietly sensed the changes brought by the Pharmacological Reasoning upgrade.

He could clearly feel that his clinical use of medications had become more flexible and precise. He now had a better grasp of subtle differences between drugs. What surprised Zhou Can the most was his newfound ability to predict the specific effects of a drug after administration and roughly estimate how much the patient would absorb. These insights formed naturally in his mind.

For instance, when treating the child in front of him with Prostaglandin E1, he could synthesize data from various test results to create a mental map. Which drugs to avoid, which could be used in emergencies, how long to wait before using certain drugs after Prostaglandin E1, and whether it would interfere with potential emergency surgeries—all of these formed a detailed drug interaction chart in his head.

This ability was something he didn’t possess at Level Five.

It felt as though he was brushing against the realm often described by masters of Traditional Chinese Medicine as Channel Attribution.

When his Injection Technique leveled up last time, he gained the ability to judge whether a patient’s skin or muscle at the injection site had reached drug absorption saturation. That skill had already hinted at the Channel Attribution realm.

If his Injection Technique could advance further to mid or even senior Chief Physician level, this ability might improve even more.

For example, right now, he could only determine saturation in specific skin and muscle areas.

With further progress, he might be able to assess whether an organ had reached drug absorption saturation.

Now that Pharmacological Reasoning had hit Level Six, it was as if he’d stepped one foot directly into the threshold of Channel Attribution.

“Director Tang, Director Le, Dr. Zhuang, I suggest we wait until the child’s condition stabilizes a bit before conducting a cardiac catheterization and retrograde aortic root angiography. With such a long segment of aortic coarctation, surgery will likely be necessary in the end. Identifying the lesion site and related conditions beforehand to rule out potential surgical risks is crucial. It will also provide a solid basis for formulating the surgical plan.”

Zhou Can felt the child’s tests were still incomplete.

Based on his surgical experience, medical treatment could only alleviate the child’s condition—it wasn’t a cure.

The best option was to wait until the baby’s physical condition allowed for surgery.

“That’s fine. If the family agrees, I’ll arrange it at the most suitable time.”

Dr. Tang Fei nodded in agreement.

“Doing an aortic root angiography is indeed necessary.”

Director Le also strongly supported Zhou Can’s proposal.

The Pediatrics Department lacked the capability to perform cardiac surgery. The child would ultimately need to be transferred to Cardiothoracic Surgery for the procedure. Completing preoperative tests beforehand would significantly reduce surgical risks and allow doctors to prepare thoroughly.

Almost all major surgeries have preoperative preparation requirements.

For a newborn undergoing aortic heart surgery, the preparations would only be more extensive.

“We have no objections at all. With so many directors and experts helping diagnose our child, we as a family feel nothing but gratitude and trust toward the hospital. We’re fully willing to cooperate with the hospital’s treatment and testing plans.”

The speaker was likely the child’s grandfather.

Though he was a grandfather, he wasn’t very old—under fifty, by the looks of it.

As for the child’s parents, they were young, just in their early twenties, and still quite inexperienced.

Major decisions were mostly handled by the child’s grandparents.

“Alright then. Thank you for your trust and cooperation. The hospital will do everything in its power. Our goal is the same as yours—we all want this clever and adorable little baby to recover and be healthy as soon as possible.”

Dr. Tang Fei wrapped up the consultation with a summarizing statement, bringing the discussion to a temporary close.

By lunchtime, Zhou Can checked his phone and saw a voice message from Dr. Tang Fei on WeChat. She informed him that the child’s symptoms had improved significantly after receiving Prostaglandin drip treatment.

The primary signs of heart failure—chest tightness and breathing difficulties—had lessened.

She also relayed that the child’s mother wanted to thank him specifically for coming up with the idea of using a dropper to feed the baby.

Though the method was a bit time-consuming, after feeding the child breast milk, the baby had slept peacefully for over two hours without waking—a scenario unimaginable in the previous two days.

The child had been crying almost nonstop, day and night.

Since infants can’t speak, they can’t tell their parents when they’re in pain or discomfort. Crying is their only natural way to express themselves.

Even adults cry when they’re in distress.

When dealing with particularly fussy newborns, especially those just born, it’s critical to be vigilant about potential illnesses or pain.

During his time in the Pediatrics Department, Zhou Can once treated a child just over four months old. The mother was on the verge of breaking down, telling Zhou Can she didn’t know why her baby had been crying incessantly for days.

The crying kept her up almost every night.

Upon examination, Zhou Can noticed a medicinal patch on the child’s navel.

After asking about it, he learned that the child’s grandmother had seen how hot the weather was and how the baby kept sweating. Worried about heatstroke, she took the child to a small clinic downstairs and got a cooling patch for children.

Some of the grandmother’s colleagues had mentioned that these cooling patches worked well.

They could prevent heatstroke and prickly heat, among other things.

The clinic ‘doctor’ also heavily promoted the patch, claiming it was pure herbal with no side effects.

Naturally, the grandmother trusted them completely.

For the first two days after applying the patch, the child slept remarkably well. Especially at noon, when the heat usually made the baby restless and unable to nap.

With the cooling patch, the child slept soundly for two consecutive days.

By the third day, though, the baby started to fuss.

By the time they brought the child to the hospital on the morning of the fifth day, Zhou Can took one look and, based on experience, immediately suspected the patch was the issue.

Carefully removing the patch, he found the child’s delicate skin red and swollen.

Worse, the navel showed signs of infection, even emitting a faint rotting odor.

Had they arrived just a day or two later, the consequences could have been dire.

The hot weather had already weakened the child’s resistance to bacteria and viruses. The navel, often called the ‘eye’ of the abdominal cavity, plays a crucial role during fetal development in drawing nutrients and oxygen from the mother.

With infection and pus already forming, if it had spread further into the abdominal cavity, a case of sepsis could have easily claimed the child’s life.