Chapter 109: Unraveling the Mystery of Paralysis

The relationship between blood and the body is like gasoline and a car.

Without gasoline, a car loses its power source. When blood fails to circulate, the body’s cells are starved of nutrients and oxygen.

Paralysis is often accompanied by issues with blood supply.

For example, patients with hemiplegia often experience a chilling sensation, poor circulation, and numbness on the paralyzed side.

“Her lower limb circulation isn’t severely affected!”

Director Yin affirmed.

So many top doctors have examined her—if such a simple issue went unnoticed, wouldn’t their reputations be unearned?

“No, no—I’m not referring to the lower limbs, but the upper limbs.”

Zhou Can’s eyes shone with determined excitement as he pursued the truth.

“Upper limb circulation is problematic?”

Director Yin furrowed his brows. If he hadn’t witnessed Zhou Can’s capabilities, he might have snapped, ‘You need more study!’ and walked away.

Yet at this moment, he showed remarkable patience and even a hint of anticipation.

This perplexing case had stumped him three years ago, and even now he couldn’t pinpoint a diagnosis.

The more challenging the case, the more it intrigued him.

At his level, ordinary cases no longer presented any real challenge.

“Paralyzed patients naturally suffer from inadequate blood flow due to muscle atrophy, especially at the extremities. Honestly, when I shook her hand, it was icy cold—which clearly indicates a problem with her upper limb circulation. Initially, my curiosity was piqued, but your insight has sparked a breakthrough.”

“Since her ECG is largely normal, overall blood flow should be fairly balanced. I suspect her general poor circulation is a result of motor neuron damage.”

Zhou Can boldly proceeded with a series of deductions and differential diagnoses.

“Hmm, that’s possible. But it doesn’t prove much; insufficient blood flow is commonly seen in paralyzed patients.”

Director Yin didn’t seem overly impressed by Zhou Can’s observation.

In fact, he appeared even a bit disappointed.

Weakened blood circulation is a typical occurrence in most paralyzed patients.

In traditional Chinese medicine terms, it’s a deficiency of both blood and qi.

“I reviewed her miscarriage history. She mentioned that after lifting heavy objects upstairs, she felt unwell and ultimately collapsed at home. Yet her initial diagnosis mentioned viral infection? or cranial nerve abnormalities?”

Zhou Can pulled up her first admission report.

It was a very rudimentary medical record.

After her collapse, the ambulance (120) rushed her to City Third Hospital based on proximity.

Post-miscarriage, she developed lower limb paralysis. City Third Hospital couldn’t determine the cause, so her family transferred her to Provincial People’s Hospital. Later, even they failed to diagnose it, and she fell into severe depression.

Her family then took her to Tuyu Hospital for further examination.

Many patients endure similar experiences—what starts as a minor ailment becomes unmanageable in ordinary hospitals, forcing a step-by-step transfer to higher-level institutions.

Three years ago, Provincial People’s Hospital’s reputation was comparable to, if not slightly superior to, Tuyu Hospital.

Now, Tuyu Hospital has long left them behind.

It has become the top hospital in the province in both medical expertise and treatment capability.

“Do you think she might have shown signs of lower limb paralysis before admission?” Zhou Can ventured another bold hypothesis.

“That seems unlikely. Before admission, the attending physician would have conducted thorough examinations. City Third Hospital’s standards and strict quality control would have noted any lower limb paralysis. Yet the records clearly state that paralysis occurred after the miscarriage.”

Director Yin was well acquainted with the strengths and practices of every hospital in the city.

At his level, he was frequently invited to exchange ideas, offer guidance, or lecture at major hospitals.

Such interactions gave him a deep insight into each institution.

“Could it be that her lower limb paralysis wasn’t apparent upon admission and was thus overlooked? The 120 report simply states that the pregnant woman collapsed in her home’s bathroom.”

Zhou Can persisted relentlessly with his theory.

“That’s quite possible.”

This time, Director Yin agreed with Zhou Can’s viewpoint.

“It’s just a pity that City Third Hospital lacks a top-notch doctor. Had they performed an electromyography test on this patient, it would have been invaluable.”

If an EMG had been conducted when she was admitted, it could have provided a solid basis for a later diagnosis.

Now, over three years later, repeating that test would yield entirely different significance.

“Director Yin, please review these reports again. This one, from Imperial Capital Renhe Hospital, is an EMG test. I compared it yesterday with several reports from healthy individuals. Qiu Jie’s nerve conduction velocity isn’t slow; rather, below the neck the EMG signal gradually diminishes—as if climbing a slope, with less attenuation closer to the lower limbs.”

“Furthermore, her evoked potential EMG and motor unit count are largely normal.”

Director Yin had already noted these findings from Zhou Can’s analysis.

“What are you getting at?”

Director Yin wondered what Zhou Can aimed to demonstrate with these details.

Pathological diagnosis is inherently complex, especially in challenging cases where differential diagnosis is exceptionally difficult.

Everyone can review the test reports.

True diagnostic skill lies in identifying one clear thread among countless details and making sense of them.

“I believe her condition stems from a problem at the source of the lower limb motor nerves. The lesion is likely above the neck; the postpartum infection is just a misleading factor.”

At that moment, Zhou Can was cutting through the uncertainty to reveal the true lesion.

“It could be an issue with the spinal nerves, or perhaps a problem within the central nervous system—the brain may be involved,” he added.

[Pathology Diagnosis Experience +0.9]

Seeing his experience points rise, his heart raced as he became even more certain of his diagnosis.

Such an almost speculative deduction would be unacceptable even to seasoned doctors or well-trained residents.

Yet sometimes, pathology demands breaking free from conventional limits rather than rigid adherence to rules.

The biggest flaw in Western medicine is its lack of flexibility.

Everything is dictated solely by test data.

Even with ample data, the final diagnosis always carries a question mark.

Why?

Because they fear being overturned, fear losing face!

In today’s Chinese medical system, doctors dread misdiagnoses and medical accidents more than anything. That question mark reflects many underlying issues.

Ultimately, it’s a sign of Western medicine’s lack of confidence.

Remember the old-school Chinese doctors? They rarely left things ambiguous. Either they couldn’t determine your ailment and referred you to an expert, or they pinpointed the lesion, provided clear pathology, and prescribed treatment.

“Why did I only gain 0.9 diagnostic experience points?”

Zhou Can was encountering this for the first time.

In previous cases, he had only received 0.2 points when multiple lesions were present and he identified just one.

This time, nearing a full point, the missing 0.1 likely meant the exact lesion hadn’t been fully determined.

After hearing Zhou Can’s diagnostic insights, Director Yin fell into deep contemplation.

A minute passed—then two, three minutes…

Soon, he found himself as entranced as Zhou Can.

Many esteemed doctors share this trait.

To conquer a disease, they sacrifice sleep, meals, and even normal life, obsessing over the diagnosis in their every waking moment.

After nearly six minutes, Director Yin realigned his thoughts with Zhou Can’s suggestions.

A spark of excitement lit his eyes.

That thrill is unique to breakthroughs in diagnosis.

“Xiao Zhou, your theory is entirely plausible. Through repeated analysis, I believe this woman’s paralysis may stem from changes in her cranial environment or compression of her cranial nerves. We can effectively rule out hemangiomas, neuromas, and osteomas.”

After all, extensive tests have been conducted.

Any brain tumor would have been detected.

“If the patient agrees, invite her for another consultation. I recommend a repeat head MRI—it will likely reveal the true lesion.”

Director Yin addressed Zhou Can.

If the patient doesn’t trust Director Yin or loses faith in Tuyu Hospital, and refuses to come, there’s nothing we can do.

“Alright, I’ll notify her immediately.”

“If she agrees to come, there’s no need for a new registration—I’ll inform the hospital accordingly.”

Director Yin offered her some convenience.

One must understand, his expedited expert appointment is notoriously hard to secure.

For most people, 800 yuan is no small amount.

“Okay, thank you! I’m sorry for taking up your time. You should get back to work!”

Zhou Can stood and took his leave.

“Don’t mention it. If you ever have any questions, feel free to ask me anytime. Your role in this diagnostic breakthrough is as significant as mine. Your innate talent in pathology is something I rarely see. This unconventional approach is truly one of a kind.”

Director Yin’s tone grew increasingly respectful toward Zhou Can.

That kid is indeed a rare talent.

“Xiao Zhou, if you’re willing to join our Neurology Department, I can arrange a transfer for you. Although the Emergency Department hones your skills, spending three months there is enough. There’s a wealth of advanced medical knowledge that’s hard to gain in the Emergency Department. Our working years are short—we rarely work past fifty.”

“Today’s medical field is becoming ever more specialized. Mastering one discipline fully is a rare achievement. With your talents, your future in Internal Medicine will undoubtedly be remarkable. Moreover, academic advancement in Internal Medicine is easier. Director Tan, a top professor, could even mentor you if you choose his program.”

Though he didn’t spell it out, Director Yin was hinting at Zhou Can.

Once you join Internal Medicine, all matters regarding academic promotion will be taken care of.

The criteria for becoming a full professor are extremely strict—only academicians qualify.

It’s hard to believe just how outstanding Director Tan of Internal Medicine is.

Indeed, Internal Medicine offers greater opportunities for academic achievement.

Director Yin’s invitation for Zhou Can to join the Neurology Department—and the many benefits offered—clearly showed how much he valued him.

“Thank you for considering my situation so thoughtfully. I’ll stick with the Emergency Department for now.” Zhou Can had long resolved to make his mark there.

He wanted to prove to those department heads who didn’t choose him that academic credentials aren’t everything.

“Mm, if you change your mind, feel free to come to me. You can even approach Director Tan directly; he holds you in high regard,” Director Yin added with a helpless nod.

If someone isn’t interested in transferring to Internal Medicine, there’s nothing he can do about it.

“By the way, have you decided on your residency training specialty?”

Even general residency trainees must choose a specific training direction after departmental assignments.

“I used to want to choose General Surgery, but now it seems I can only opt for Emergency, right?”

Zhou Can wasn’t entirely sure about the hospital’s arrangements for general residency trainees.

Both he and Jin Mingxi were assigned to the Emergency Department, so he assumed their training direction would indeed be Emergency.

“Choosing Emergency as your training direction isn’t bad—you can always switch later. As for General Surgery, I’d advise against it. That path is too narrow. Its prospects are far less promising than those in Neurosurgery or Cardiothoracic Surgery. And regarding Internal Medicine, Neurology and Cardiothoracic Internal Medicine have the brightest futures.”

Director Yin personally guided his training direction—a clear sign of how much he valued Zhou Can.

“Thank you for your thoughtful advice. I’m truly touched.”

This is how Zhou Can and Director Yin, once at odds, grew to respect one another.

Their first meeting saw Director Yin publicly admonish him, leaving a very poor impression at the time.

Yet, Zhou Can’s excellent performance and humility gradually won Director Yin over.

…

After leaving Neurology, Zhou Can immediately called Mr. Li.

“Lao, it’s me. Yesterday…”

“I know, Zhou Can! Why don’t you come over to my place today?”

Mr. Li and he had hit it off during their chat yesterday.

No sooner had Mr. Li spoken than he was invited over.

Perhaps Mr. Li was simply bored at home with his wife.

“I’m not going today; I’m still in residency training and need to hone my surgical skills! Sigh, being a doctor is truly tough!”

Zhou Can sighed.

“Ha, what did you expect when you chose this field? Regretting it now?”

Mr. Li burst into laughter.

“Not to the point of regret. After all, I love this profession. Brother, remember—didn’t you get my sister-in-law’s test results yesterday? I had a few professors review them. After Director Yin from Neurology examined the data, he made a breakthrough discovery. His suggestion is that if you and your sister-in-law agree, she should undergo another consultation, possibly including a head MRI.”

Zhou Can dared not indulge further in chit-chat with talkative Mr. Li.

Instead, he quickly got down to business.

Otherwise, he’d end up in hours-long conversations on topics of common interest.

He did enjoy chatting with Mr. Li, as it broadened his horizons and taught him much.

But for now, he was focused on mastering his surgical skills.

After all, there would be plenty of time in the future for good times over wine.

“Really! That’s fantastic news!”

Mr. Li was ecstatic upon hearing the breakthrough.

Zhou Can even suspected that Mr. Li had jumped up in childlike joy.

“I always knew you were sincere. I never expected you to care so deeply about my wife’s illness. Brother, needless to say, I’ll always remember your kindness. Even if your sister-in-law’s condition remains undiagnosed after tomorrow’s exam, I will forever be grateful for your support.”

Mr. Li, who once nearly became president of Tianyu Interactive, was exceptionally adept at judging people.

Despite his freewheeling style, his talent and ability were undeniable.

He was straightforward in his dealings and despised pretense.

This sincerity was evident in every conversation they had.

He never played any mind games when speaking with Zhou Can.

“Hey, wasn’t Director Yin’s name supposed to be Yin Hua?” Mr. Li suddenly asked as if recalling something.

“Yes! Looks like you remember him. When I showed him my sister-in-law’s data today, he was deeply impressed by her condition. He mentioned it was particularly regretful that he couldn’t diagnose her correctly three years ago.”

“So it really is him. I’ll take my wife to see him tomorrow.”

Mr. Li was extremely devoted to his wife’s treatment.

Upon hearing of the diagnostic breakthrough, he was overjoyed.

Even though each consultation ended in disappointment, he never gave up hope.

He remained relentlessly determined.

“Director Yin said you wouldn’t need to register. But I feel that out of respect, you should still register.”

Zhou Can adhered to his own principles.

He believed Mr. Li wouldn’t mind the 800-yuan registration fee.

“Registration is essential—I know that, brother. But Director Yin’s appointment is notoriously hard to secure, often falling prey to those despicable scalpers.”

Mr. Li, who frequently sought medical help for his wife, had clearly suffered due to scalpers.

Thus, he harbored deep resentment toward them.

“There’s no need to buy appointments from scalpers. We’ve already arranged it—you just need to ask Director Yin to add an appointment.”

Zhou Can offered this suggestion.

Innately ethical, he would never promote any malpractice unless absolutely necessary.

If patients refrain from buying appointments from scalpers, that corrupt practice will naturally vanish.

After the call ended, Zhou Can felt elated.

Being true to one’s word is a mark of integrity, and if everything goes well, a favorable outcome will follow soon.

He also wanted to determine exactly where Qiu Jie’s lesion was located and what its true cause was.

He was confident that after tomorrow’s tests, Director Yin would pinpoint the exact pathology.

The mystery would finally be unraveled.

The end.