Chapter 238: A Day in the Gastroenterology Clinic

Chief Resident Luo Shengsheng from the Gastroenterology Department basically honored Zhou Can’s every request.

This special treatment was reserved for Zhou Can alone, the only trainee who got such privileges.

Don’t underestimate how convenient these invisible perks are. They can really make a difference, especially on night shifts. With other doctors and nurses keeping an eye on patients, Zhou Can could sleep soundly in the on-call room.

Some trainees have to work 36-hour shifts. That level of non-stop intensity—if you don’t sneak in a few naps now and then, even an iron man couldn’t handle it.

Catching a few hours of sleep on shift is the only way to stay refreshed for the next day.

It also keeps you from dropping dead from exhaustion.

……

He went straight to VIP Specialist Clinic Room 1. It wasn’t even one in the afternoon yet, but both the corridor outside and the waiting hall were already packed with patients.

Modern life might have improved, but all the overeating and poor diets meant digestive diseases had only gotten more common.

Add in hectic work schedules, rushed meals at odd hours, eating on the fly—

Live like that long enough, and your digestive tract will start acting up.

The most common problems are stomach ulcers and enteritis.

What many don’t realize is that stomach ulcers massively increase your risk for stomach cancer.

As for constant overeating, that’s even worse. It overloads your body, jacking up risks for liver, kidney, and cardiovascular diseases.

Zhou Can had arrived at just the right moment.

Director Shang was there too, bringing along an outpatient nurse, an assistant doctor, and three graduate students.

In hospitals, any director with academic chops was usually an associate or full professor. Besides practicing medicine, they also taught at Tuyu Medical College.

Normally, when a director did outpatient duty, their assistant doctor was someone the department was grooming for big things.

You could say it was like accepting a personal disciple.

There’s a saying in medicine: to treat an illness, you have to diagnose it first.

Every treatment begins with diagnosis—find the cause, then treat accordingly.

If you don’t figure out what disease the patient actually has, or where the problem is, you could end up losing them. Treat the wrong thing, and you’re just as likely to kill as to cure.

The hospital had its own way of training up new talent.

Usually, you’d intern in the ward for a year, then train for one to three years. Once you’d built up experience handling admissions and different diseases, you could gradually start shadowing your mentor in the clinic.

Here’s something important: hospital physicians from the inpatient unit only got to run outpatient consultations once a week.

That’s right—just one full day at the clinic.

As for director-level or superstar doctors, the hospital would have them work 24/7 in clinics if it could.

Realistically though, they’re buried with admin, research, teaching, operations, meetings, consultations in other departments and sometimes even outside the hospital. Often, the hospital has to mandate that they spend at least a certain number of days a week seeing patients.

For example, Director Shang was required to do at least two clinic days a week, but he was extremely busy. If a case couldn’t be handled by his attending or resident doctors, he had to step in personally.

On top of that, he had research, lectures, supervising students, performing interventional surgeries, countless meetings, consulting in other departments or even other hospitals, and more.

To put it simply, his schedule was beyond packed.

So he’d squeeze in clinical hours wherever possible—Monday morning, he could do half a day; Tuesday afternoon, another half.

That’s why, when patients try to book appointments, they find the experts and professors keep odd, unpredictable hours—like guerilla warfare.

In truth, these ‘national treasure’ level directors were already doing their best to carve out time for patient care.

The fact that Zhou Can, a trainee, could join Director Shang for clinic duty—well, that was a reward from Director Shang.

It was also a nod to his work ethic and professional ability.

“Dr. Zhou, did I keep you waiting?”

Director Shang greeted him warmly, an approachable smile on his face.

“Not at all, I just got here. It was unreal—on the way, the halls and waiting room were packed. I had no idea outpatient clinics in Gastroenterology were this busy!”

Zhou Can started the small talk to lighten the mood.

He didn’t want the conversation to fizzle out awkwardly.

“Heh, this is nothing—the morning clinics are even busier. Actually, a department’s success is reflected in its outpatient numbers. Ever since we set up a dedicated endoscopy and interventional unit in Tuyu Gastroenterology, patient satisfaction has soared. Word of mouth brought us to where we are today.”

Director Shang was the driving force behind the Gastroenterology Department.

Talking about the department’s growth, his face and eyes radiated pride.

It was the prosperity he’d worked for years to achieve.

A shining testament to his leadership of Gastroenterology.

“Oh, let me introduce everyone. This is Zhou Can, our rotating resident. This is Dr. Huang Xinggui, the attending in coloproctology. And these three are my graduate students: Qiu Chengyu, Xie Lin, and Luo Jingyin.”

They say Internal Medicine has a lot of women doctors.

Of the three graduate students with Director Shang, two were women—guess the rumors are true.

“Hello, it’s great to meet you all. I hope you’ll look out for me from now on!”

Zhou Can kept a low profile, being polite even with the graduate students.

“Hello!”

“Dr. Zhou’s pretty handsome!”

“If you run into tough coloproctology cases, feel free to discuss them with me anytime!”

Three of the four welcomed Zhou Can warmly.

The lone exception was the male grad student with the long, horse-ish face, who seemed distant.

Some folks are naturally quiet and introverted. Zhou Can didn’t mind.

They followed Director Shang into the exam room.

Patients and their families queuing outside were all smiles when the specialists arrived.

The consulting room wasn’t big—maybe about twenty square meters.

There was a basic exam bed against the wall for patients who needed to lie down for checks.

A circular curtain hung over the bed.

Draw the curtain, and you had a private space.

Whenever a particularly private exam was needed, doctors would close the curtain.

Of course, in the hospital, sometimes you just have to be brave and cooperate.

As much as possible, don’t try to hide anything from your doctor.

For example, when Zhou Can sat with Mr. Liu seeing patients, if a woman with a breast condition came in, they sometimes had to examine or even palpate the affected area. In these cases, privacy protections were usually minimal.

After all, besides the physician, their assistant, and the patient with their family, nobody else was in the room.

Sometimes, a nurse would assist as well.

“Dr. Huang, you’ll assist me with consultations. The rest of you, observe. Xie Lin, take notes and enter test requests into the computer. For now, Zhou Can can help guide patients in and out.”

As soon as they sat down, Director Shang assigned everyone their roles.

Even the most rural clinics nowadays could handle prescriptions and test requests directly through the hospital network.

Every department could access relevant information on the spot.

Inputting all that data was usually a young doctor’s job.

That’s why senior doctors love teaching students.

They get plenty of help with all the grunt work. Supervisors definitely benefit from having junior staff around.

Escorting patients might be the least desirable of all these chores.

Having Zhou Can do it was a subtle sign that, in Director Shang’s eyes, he didn’t rank as highly as Dr. Huang or the three grad students.

That was fine with him.

Zhou Can excelled at standing out in tough spots. He’d work his way up and earn the seniors’ respect, just like always.

He was fully confident he could surpass those around him.

“Knock knock knock!”

Hearing the knock outside, Zhou Can didn’t wait for instructions and quickly opened the door.

A patient and her family entered the consulting room.

Zhou Can closed the door behind them.

The doctor-patient interaction was always one-on-one.

No way could you cram the tiny exam room full of people.

Patients waiting outside were well aware of the rules. No barging in. Everyone waited their turn politely by the door.

“Doctor, could you help my daughter? Lately she’s always complaining about a bloated stomach and eats much less than before. Sometimes she says her belly hurts, too.”

The family member was a woman in her forties. She’d brought her daughter, probably about eighteen or nineteen, for help.

Generally, young people are healthy.

These symptoms indicated something might be wrong inside.

“Have you taken her to any other hospital for tests yet?”

“No, we came here specifically for your reputation. Grandma Wang from our neighborhood always raves about your skill. Even my coworker says you cured her long-term stomach pain. This is my only child, so I’m just really scared something bad might happen. Please, pay extra attention.”

They’d come seeking a famous specialist.

Doctors built their reputations bit by bit, with every patient they helped, and word spread.

Add the hospital’s publicity and undeniable professional skill, and eventually that nameplate of ‘famed doctor’ was earned.

It wasn’t an easy journey.

“Miss, when do you feel bloated? Does it happen after meals, or is it random?”

Director Shang asked, his tone gentle and kind.

The girl, barely out of her teens, looked timid and shy.

“Um… Sometimes it just feels really bloated, and the feeling stays for a long time. Occasionally it starts in the morning and lasts till afternoon, or from the afternoon into the evening.”

Director Shang took notes as he kept questioning.

“Your mom mentioned you’re eating less than before. Is that because you have no appetite or are you secretly snacking more these days?”

“No, I barely touch snacks now. Back then I used to eat them all the time. These days, even if I’m hungry at mealtime, I can only manage a few bites before I feel full. Oh—and the bloating mostly happens after I eat. Sometimes I even feel nauseous and burp out of nowhere. It’s really uncomfortable.”

She started describing her symptoms.

Director Shang nodded.

“Luo Jingyin, take her blood pressure, temperature, and pulse.”

Having extra doctors was always a blessing.

You could get multiple things done at once, which boosted efficiency.

“Miss, do you feel bloated right now?”

Director Shang pressed on with his evaluation.

“Yeah, a little.”

“Which part hurts?”

“Here, right in this spot.”

Vitals were quickly checked. The basic physical exam and initial questioning were wrapped up.

Peeking at the exam form, Zhou Can noticed Director Shang had marked ‘malnutrition.’

The girl really was awfully thin.

Those older women who weighed over 130 pounds would be downright envious of her slim figure.

“Alright, we’ve pretty much gathered all the basic info—symptoms, vitals, and medical history. The four of you, what tests do you think we should order next?”

Clearly, Director Shang was posing this question to the three grad students and Zhou Can.

Meanwhile, attending Dr. Huang just wore a knowing smile, looking confident—he’d obviously already decided what tests should be run.

“I think we should start with a gastroscopy!”

Qiu Chengyu was the first to answer.

So much for being a quiet type—turns out he wasn’t shy at all.

“I think a CT scan of the stomach is better. That way we can check for tumors and such. Might as well look at the duodenum while we’re at it.”

Xie Lin’s thinking went a bit overboard—even brought up the duodenum.

That’s the classic mistake for med students without experience—if a symptom fits one or two conditions, they’ll toss every disease in the book into consideration.

The more experienced a doctor, the fewer tests they need.

With a patient’s summary and overall symptoms, they ruled out unlikely possibilities on the spot.

After seeing enough cases, a veteran could figure out the most probable diagnoses just by pressing the patient’s abdomen, asking about symptoms and duration, age, gender, job, and lifestyle.

That way, they targeted the right tests.

They could find the problem in the shortest possible time, with as few tests as needed.

“I’d recommend a full blood panel first, then follow up based on those results.”

Luo Jingyin was the quiet scholar type. She suggested a blood test, which was the most common hospital test. Nearly every inpatient got one.

Some hospitals, to play it safe, required way more pre-admission tests.

That often annoyed patients and families, who felt hospitals were just fishing for extra test fees.

Director Shang listened to the three grad students but didn’t comment.

Instead, he turned to Zhou Can, who hadn’t spoken yet.

“What’s your opinion, Dr. Zhou?”

Compared to the inexperienced grad students, Zhou Can appeared much more steady.

“Uh… If we want to minimize delays and help the patient get effective treatment ASAP, I’d order a full blood panel, a Helicobacter pylori test, and a gastroscopy.”

Zhou Can said his piece—three tests in total.

Compared to the scattered suggestions from the others, his choices were much more like a seasoned clinic doctor’s.

“Heh, looks like Dr. Zhou has serious skills—not just in surgery and patient management, but your outpatient judgment is way beyond an average resident’s.”

Director Shang praised Zhou Can with a big smile.

Even Dr. Huang, the attending, gave Zhou Can a new look.

This young trainee really did seem capable beyond his years.

Never mind the graduate students—even the senior inpatients under Director Shang would have a hard time matching Zhou Can.

“Xie Lin, log Dr. Zhou’s recommended exams. We’ll order all three.”

Director Shang instructed Xie Lin accordingly.

The mother’s face clouded over with doubt.

She finally couldn’t help but speak up: “Director Shang, we came for your reputation, and even paid hundreds for a VIP specialist slot. Please don’t let these new doctors treat my daughter! I know they need experience, but you can’t let them make the calls!”

Her only child was involved—she was worried the young doctors would bungle things.

If her daughter’s condition worsened, who could she turn to?

She wasn’t about to take that risk.

Hundreds of yuan and a lot of hassle just to secure a special appointment—no one would accept being treated by an intern after all that effort.

“It’s not that I’m following the junior doctors’ plans—it’s just that Dr. Zhou’s three recommended exams matched the tests I’d already planned. That’s why I said his clinic skills are impressive.”

Director Shang patiently explained with a smile.

“Oh, I see! Sorry—I misunderstood you,”

The mother’s worries melted away. She offered a sheepish smile.

She found herself glancing over at Zhou Can.

Her daughter did too, sizing up this young doctor who clearly outshone the rest.

Zhou Can kept his cool, unfazed.

He’d heard it all before—praise from the vice dean, the dean, the works.

With so many compliments over time, he was almost immune to them.

Still, it felt pretty good to hear.