Chapter 240: A Healer’s Heart: Diagnoses and Dilemmas

Earlier, Dr. Zhou suggested that the female patient’s family members get tested for H. pylori as well. It’s a great suggestion, but in real clinical practice you have to be careful about how you approach it. Ideally, wait until the patient’s tests are finished, H. pylori infection is confirmed, and you’ve explained the diagnosis and treatment plan. Once both the patient and her family accept the treatment, then you can find the right time to bring it up with them.

If the family reacts negatively, don’t push it. As doctors, the first thing we need to learn is how to protect ourselves. Some family members can be very short-tempered—they might not appreciate your concerns, and if yelling is the worst they do, consider yourself lucky. There have been cases where relatives have thrown things at doctors.

Director Shang, speaking from experience, shared stories of times he’d been attacked with these young doctors.

If you’ve ever paid attention at a hospital, you’ll notice the doctor’s chair is always a sturdy, black leather armchair. The seats for patients and family, meanwhile, are just little plastic stools.

Many people think this is discrimination against patients, but that’s really not the case.

Some hospitals used to give patients good-quality steel stools. But then a family member once used one of those to hit the doctor so hard he broke a bone.

The nurses were so scared they hid under the desk.

And that wasn’t even the only time something like that happened—it’s more common than you’d think and always infuriating.

Afterwards, the family will definitely face legal consequences.

But for the hospital, an injured doctor is a huge loss. Especially if they’re an expert in their field—if they’re hurt on the job, they can’t work anymore.

It doesn’t just stop at their appointments getting cancelled. Every patient under their care, whether for surgery or medication, has to be handed over to another doctor.

When a new doctor steps in, they’re not familiar with those patients’ conditions. Not making a mistake is probably the best you can hope for.

Naturally the overall quality of care goes down.

While the injured doctor is recovering, the hospital still has to pay their salary and provide workers’ compensation and support.

All that adds up to major losses for the hospital.

Imagine—today one doctor gets his arm broken, tomorrow another gets his eyebrow bone fractured. If doctors are always worried about being attacked, it’s bound to affect how well they diagnose patients.

That constant worry lowers care quality, too.

Eventually, hospital leaders came up with a solution: they replaced every chair for patients in outpatient rooms with plastic stools.

Now, even if a furious family member acts out, the doctor at worst ends up with minor injuries.

This practical idea spread across the country and is now a standard for outpatient clinics.

“Xiao Qiu, go open the door and call the next patient in! Dr. Zhou’s thinking is flexible, and his foundation in basic medicine is solid. He’s also quick to apply it in clinical situations—something all of you should learn from.”

Director Shang couldn’t stop praising Zhou Can’s performance.

What’s more, they didn’t even have Zhou Can handling the “doorman” duties anymore.

“Ah… sure!”

Qiu Chengyu froze for a second, then his face fell noticeably.

Everyone’s competing on ability here.

He’d just been thrashed by Zhou Can in round one, completely losing the upper hand.

So of course Director Shang would have him handle calling patients.

The door opened, and a thin woman in her late thirties entered, carrying a middle-aged man who towered over her on her back.

The man looked frail and visibly ill.

You could tell in an instant he was malnourished.

Malnutrition usually falls into three types. First, not eating enough and surviving on a monotonous, low-nutrition diet for too long—that leads to weight loss.

Second, the presence of a malignant disease inside the body, like a tumor or leukemia, causing the patient’s weight to plummet.

Cancers grow rapidly, devouring the body’s resources and causing sudden weight loss. They can also suppress appetite so patients don’t feel hungry or want to eat.

Third, digestive trouble. Some people develop poor digestion due to gastrointestinal issues—either they’re full after one meal all day or their gut can’t absorb nutrients well, so they only take in a fraction of what they eat.

The rest just gets passed out.

And it’s not just in the bowel—urine also carries out a lot of nutrients.

Proteinuria is a classic example.

“Can he sit?”

Seeing the determined way this “lady warrior” gritted her teeth and carried the patient, Zhou Can quickly hurried over to help.

It was just a small gesture of kindness.

Director Shang said nothing, but the approval in his eyes as he looked at Zhou Can was obvious. In contrast, his gaze grew colder when he saw Qiu Chengyu just opening the door for the patient.

Compassion is the baseline for every doctor.

Without a caring heart, you can’t call yourself a true doctor.

“He can sit—he’s just too weak to walk.”

The woman gave Zhou Can a grateful smile.

“Slowly, take it slow!”

Zhou Can helped steady the man, guiding him gently onto the chair.

This patient had to be at least 6’1″ or 6’2″, while the woman wasn’t even 5’3″. Imagine how grueling it’d been for her to carry him all this way.

Don’t be fooled by his thin build—with a frame that big, he probably still weighed over 130 pounds.

“Thank you!”

The woman thanked Zhou Can.

“No need to thank me. What’s wrong with him?”

Zhou Can noticed the man’s eyes were completely dull. His hair was shaved close to the scalp, probably for hygiene. His cheekbones, collarbone, and wrist joints all jutted out sharply.

His skin was dark and sallow.

This was a classic case of someone looking haggard and underfed.

You could even hear his labored breathing.

It sounded like a donkey moaning under a heavy load.

The patient hadn’t walked a single step—he was carried in. Even sitting there looked exhausting, showing just how close he was to total collapse.

Seeing him in such dire straits, Zhou Can couldn’t help but feel worried.

“I have no idea what’s wrong. He keeps throwing up whatever he eats, and his appetite just gets smaller. We’ve been to so many clinics, both Chinese and Western medicine. He’s tried all sorts of meds. His weight dropped from over 170 pounds to just above 130. We’ve done so many tests, but no one can pin down the cause.”

She handed Zhou Can two big white plastic bags.

Inside were all sorts of test reports and medical images.

“This is Director Shang—he’s my supervisor. Let’s ask him to take a look, too.”

After taking the bags, Zhou Can naturally introduced Director Shang, setting the files in front of him.

It might seem simple, but handling a situation like this really tests your people skills.

Once again, Zhou Can passed with flying colors.

By introducing his teacher, he showed respect while keeping things comfortable for everyone.

Director Shang picked up one bag and began looking through the test results.

“Wow, you two have done a lot of tests! I see quite a few repeats here, too.”

“There’s no choice. A lot of hospitals won’t accept another hospital’s results. They always make us redo them. The more hospitals we go to, the more tests pile up. He’s had three MRIs already!”

The woman sighed—it was clear she’d bottled this frustration up for a while.

Each round of tests meant hours waiting in line and a hefty bill.

Even the cheapest MRI costs three to four hundred per session. Some charge over 500. The more advanced scans can run up to a thousand or even two thousand.

Some doctors just stick to the letter of hospital policy.

In the name of department profits and meeting quotas, they order extra MRIs and CTs despite knowing how much radiation is involved. It’s not safe, but they still make patients redo scans again and again.

That’s just plain unethical.

“How long has he been sick?”

Director Shang flipped through test reports as he asked about the medical history.

“It’s been over a year since all this started. My husband had a big work party, drank way too much one night, and a coworker had to drive him home. He’s gotten that drunk plenty of times. Usually after a good night’s sleep, he’s fine, but that time, the next morning, he ate breakfast and immediately vomited. I thought it was just a hangover…”

She gave a rough outline of his medical history.

According to her, his vomiting issues began a year ago after that night of binge drinking.

But the vomiting episodes were strange.

At first, it didn’t happen every time—sometimes he’d keep food down just fine.

Other times he’d throw up, with no pattern or warning.

They first blamed heavy, greasy food.

But after lots of observation, they realized the vomiting wasn’t tied to any particular food.

If he was going to throw up, he’d do it no matter what he ate.

If he was having a good day, anything went down fine.

The episodes became more frequent, too. At first, it happened every couple weeks. Now, it’s almost daily—he even throws up water.

“Has he had a gastroscopy?”

Attending physician Dr. Huang Xinggui asked the family.

Right now the patient could barely catch his breath, making it impossible for him to answer himself.

“Yes, he’s had both a regular and capsule gastroscopy. All the results are in the bags—want me to dig them out for you?” The woman’s tone was deeply respectful.

To her, as long as her husband can be cured, she’d crawl on the ground if that’s what it took.

Honestly, this patient was lucky to have such a devoted wife.

Several of the young doctors even started to believe in true love.

“No need, just help keep him steady. Make sure he doesn’t fall; that stool doesn’t have a backrest,” Dr. Huang waved his hand. He started pulling out all the reports, receipts, and photocopied records from the bags.

Hospitals usually keep original inpatient records for their own documentation.

Patients can choose to make their own copies upon discharge.

Some hospitals do the same with test results—you have to request and copy them yourself.

If you see patients online complaining that hospitals refuse to give them records or results, don’t worry. Any legitimate hospital will give them to you as long as you ask.

Zhou Can didn’t jump in to look at the tests just yet.

As a trainee, he’d just earned preliminary recognition from Director Shang, so he stuck to what a student should do.

He’d have a look once his supervisors finished.

He stood behind Dr. Huang and Director Shang, following along as they looked through the reports.

Luo Jingyin also crowded over to stand beside Zhou Can to follow along.

Cases like this always spark the interest of medical students.

Everyone wanted to know what could possibly be making this patient so ill.

After all those years of study, of course every doctor wants to put their knowledge to use.

Diagnosing a tough case using everything you’ve learned fills you with a sense of pride and accomplishment.

“The gastroscopy looks normal to me, right, Dr. Zhou?”

Luo Jingyin tucked her stray hair behind her ear, revealing her delicate features.

Zhou Can hadn’t expected the shy, quiet Luo Jingyin to speak up first.

He blinked in surprise before saying, “If Dr. Luo says it looks normal, I trust her judgment!”

“It’s not that I’m uncertain—just inexperienced. I wanted your input to make sure I’m right,” she explained in a whisper.

“Heh, I’m just a rookie too. Let’s listen to what the supervisors say.”

After showing some skill, Zhou Can had quickly risen in her estimation.

Even when she was confident about the results, she wanted Zhou Can’s second opinion before committing.

“Jingyin, you read it correctly—the gastroscopy showed nothing unusual.”

Qiu Chengyu joined them.

But Zhou Can noticed a telling detail: when Qiu Chengyu stood next to Luo Jingyin, she instinctively shifted closer to Zhou Can.

Girls rarely show their feelings on their face.

It’s nearly always in their actions.

That subtle move said loud and clear she wasn’t interested in Qiu Chengyu.

“Oh.”

She answered him quietly.

Director Shang and Dr. Huang went through every paper in the medical file, checking treatment history and medication.

The patient had been hospitalized before, more than once and in several hospitals.

But every attempt had ended in failure.

Likely overwhelmed by medical bills, the family finally brought him home.

As Director Shang picked up an MRI, Qiu Chengyu edged even closer, even leaning in toward Luo Jingyin.

She was now almost pressed up against Zhou Can, with nowhere else to go.

Her brows pinched together—she was clearly uncomfortable, but too shy to speak up.

Zhou Can really couldn’t stand guys who wouldn’t take a hint and kept getting in a girl’s space.

If both people are into it, it’s fine.

But pushing yourself on someone? That’s just wrong.

It’s workplace harassment, plain and simple.

“Dr. Qiu, your eyesight seems off. If you can’t see, feel free to move closer to my side,” Zhou Can said, stepping in to help.

Hearing he could stand on Luo Jingyin’s right, Qiu Chengyu perked up and immediately agreed.

He shuffled over instantly.

“Dr. Luo, could you move down a bit?”

Zhou Can motioned for Luo Jingyin to slide closer to Xie Lin.

Then he positioned himself between Qiu Chengyu and Luo Jingyin, separating them entirely.

At first, Qiu Chengyu looked pleased, but the moment he realized what Zhou Can was doing, his face clouded over.

Luo Jingyin gave Zhou Can a small, shy smile.

Most women are sensitive and perceptive; she definitely knew Zhou Can was looking out for her.

In the workplace, inappropriate behavior from male coworkers or supervisors usually starts subtly—just like this, with ‘accidental’ closeness.

Often, women can do nothing but put up with it.

After all, if he doesn’t cross a clear line and everyone still has to work together, sometimes you just have to grit your teeth and endure.

It took nearly twenty minutes for the senior doctors to finish going through every file and test.

Dr. Huang Xinggui frowned, deep in thought about the possible diagnoses.

Director Shang’s expression was grave—he was clearly pondering hard.

“Dr. Zhou, you’re great at this. Any idea what it could be?”

Luo Jingyin asked quietly, trusting Zhou Can with the question.

She seemed to trust Zhou Can a lot—maybe even more than she realized.

“Great? Not me. The last two diagnoses were lucky guesses, that’s all. Let’s wait for the real experts to weigh in.”

The senior doctors hadn’t said anything yet.

How could Zhou Can dare to jump to a conclusion?

Besides, this case was so strange—Zhou Can wasn’t a miracle doctor. He was a long way from being able to call this on his own.

Even shadowing Mr. Liu in General Surgery on those tough cases, he’d missed plenty of diagnoses himself.