Chapter 254: Steady Progress and a Second Chance

Not only did this patient make a full recovery and leave the hospital, even the stomach cancer patient has now been discharged. They’ll still need regular chemotherapy and follow-up visits at the hospital, though.

The female lawyer with cirrhosis also showed clear improvement after her surgery.

She was actually discharged three days ago.

But cirrhosis is a common chronic progressive liver disease that results from one or more causes acting over the long term, leading to widespread liver damage.

And once that damage sets in, it’s usually irreversible.

The liver and kidneys are pretty similar in this way.

Once they’re harmed, it’s nearly impossible for them to go back to normal.

So the best approach is always early detection and early treatment.

However, compared to the kidneys, the liver does have a strong ability to regenerate. If the liver tissue is in good shape, it can even bounce back after 80% has been removed.

But with cirrhosis, the liver is already in a compensated stage, so that regenerative ability is affected and nowhere near what it would be if it were healthy.

If it progresses to late-stage cirrhosis, or decompensated cirrhosis, the liver is basically shot.

At that point, even routine surgery isn’t an option unless the patient can physically handle it.

For this female lawyer in Bed 79, things actually turned out as well as they could. Her cirrhosis was caught early. Once the real cause was found and addressed with surgery, the hidden threat was removed.

From now on, she’ll just need to take medication long-term to protect her liver, and for the most part, her daily life shouldn’t be too affected.

Speaking of which, when Zhou Can wrote the discharge orders for this patient, he actually earned a reward of 100 Pharmacological Reasoning experience points!

This was also his very first time writing discharge orders for a liver disease patient.

His Pharmacological Reasoning skill has now reached level four, with a current experience of 227—solidly at the lower tier of the Attending Physician level.

He’s not in the absolute top tier, but he’s way ahead of many others.

Not just among trainees—with this kind of skill, even among resident physicians, he definitely stands out from the crowd.

Every doctor knows that Pathology Diagnosis and Pharmacological Reasoning are the hardest medical skills to level up, rivaling even skills like Anesthesia Technique. Plenty of doctors spend an entire career studying medicine but never advance past the Attending level.

It’s not just because their academic papers hold back their promotion to Associate Chief Physician—honestly, it’s often because some doctors, once they start working, lose that initial drive and don’t want to work as hard as they did back in school.

So they end up working until retirement never reaching higher levels of Pathology Diagnosis or Pharmacological Reasoning.

If we’re talking traditional Chinese medicine, besides Pharmacological Reasoning, there’s actually an even tougher skill known as Channel Attribution.

It’s a high-level technique for advanced prescribing.

Mastering Pharmacological Reasoning lets you tailor treatment for specific illnesses—understanding which medicine suits which disease, how to combine drugs, the right dosages, and proper administration. All of it can be managed with precision.

Still, compared to top-tier TCM experts or leading internists, there’s a noticeable gap.

That’s because they all know the advanced skill called Channel Attribution.

It’s often just called Channeling.

Take Director Tan from Internal Medicine—he actually went out of his way to study TCM theory, reportedly becoming an apprentice to several old-school TCM masters, all to really get to grips with Channel Attribution.

No wonder he became a first-level professor, was named an academician, and serves stably as the chief of Internal Medicine. He’s not just well-known by chance.

Director Tan’s accomplishments in his field make him a leading figure among internal medicine experts nationwide.

He just keeps a low profile and doesn’t chase after fame, which is why he isn’t as well-known as Wu Baihe.

Even Director Yin Hua from Neurology is more famous than Director Tan.

Yet whenever he’s around Director Tan, Yin Hua always acts as respectful as a student.

Just like Director Tan, many others who reach a certain level of success in medicine go on to study TCM in depth. Almost all renowned internists go this path. It’s like how famous scientists eventually turn to theology in their later years.

Newton, Einstein, Edison—all of them, as they aged, shifted from science toward theology. No one really knows why.

People guess it’s because the more they understood, the more they realized there were things science just couldn’t explain—so they began to believe there must be a higher power.

Following that logic, maybe Chinese internal medicine doctors dive into TCM after a certain point because they’ve seen plenty of cases that modern medicine can’t explain.

Instead, they often find the answers they seek in traditional TCM theory.

So it’s only natural that they end up exploring TCM deeper.

Despite how fast Western medicine has advanced, Western pharmaceuticals still completely dominate over traditional Chinese medicines. They’re the market standard.

But once you bring up Channel Attribution, foreigners just shake their heads and say ‘no, no’.

That’s because Western medicine doesn’t even recognize things like meridians or acupoints.

They don’t know the first thing about meridians, so talking about Channel Attribution is like speaking gibberish to them.

Right now, Zhou Can’s Pharmacological Reasoning is at level four—a new milestone in his grasp of drug theory and effects. But compared to medical heavyweights like Director Tan, he’s still got a long way to go.

He’s still pretty fuzzy on the concept of Channel Attribution.

Still, that’s way ahead of most foreigners—at least Zhou Can knows some basics about meridians and acupoints.

That morning, just like always, Zhou Can got to the ward bright and early to check on his patients.

The number of patients under his care had grown from seven to eleven, thanks to Director Shang. Over the past week, some of his patients have been discharged, while others are newly admitted.

So far, every patient he’s treated has seen clear improvement. He hasn’t run into any unsolvable medical problems yet.

If a patient needed an endoscopic surgery, he performed it. If they needed an intervention, he did that. If it was time for medication, he prescribed it.

Every patient under his care was able to start proper treatment within two days of admission.

That’s exactly why Director Shang keeps giving him more responsibility—his management is just that good.

Zhou Can was happy to take on the challenge.

Ever since his Pharmacological Reasoning skill leveled up to four, his ability to write all sorts of prescriptions jumped a notch. He could select medicines, combine them, and manage dosages with way more accuracy.

Take fever medications, for example—he can now choose from options like ibuprofen, aspirin, acetaminophen, indomethacin, nimesulide, celecoxib, and more.

Back when he operated at a basic resident level, all he cared about was bringing down the fever as fast as possible.

Now that he’s at attending physician level, he considers the patient’s age, sex, underlying diseases, causes for the fever, and other factors before making a decision.

He’s clearly more thorough and careful now.

The benefit is that it greatly reduces the adverse effects from drugs and makes sure treatment fits each illness.

In this sense, the difference between a resident and an attending when it comes to prescribing is like night and day.

“Dr. Zhou, can you take a look at the patient in Bed 65 for me?”

Zhou Can was making his rounds when Yu Xin, the female trainee in his group, approached him.

“What’s up?”

He turned around to ask.

Since joining the Gastroenterology Department, everyone could see Zhou Can’s patients always improved under his watch.

People might not say it out loud, but deep down they really respected his abilities.

Yu Xin, in particular, was one of his biggest admirers.

“It’s that elderly lady who got salmonella last time. She just got transferred back to the ward from Critical Care. I’m honestly a bit scared—her condition is still pretty serious and I’m not confident in handling it alone. I’d be a lot less worried if you double-checked for me.”

Yu Xin explained.

Now, whenever she faces someone she can’t quite handle, she always turns to Zhou Can for help.

Compared to asking Director Shang or Dr. Huang Xinggui, it’s way easier getting help from someone at her level—even if he’s got skills far beyond the rest.

Plus, it takes a lot of pressure off her mind.

“Sigh… that elderly woman really should’ve seen a doctor the moment she got salmonella. If only she’d listened at the start! Instead, she waited until it was life or death before coming to the hospital. At least she survived—could’ve been much worse.”

Zhou Can shook his head and sighed.

He followed Yu Xin to the room where Bed 65 was located.

The elderly lady’s husband had already been discharged.

But as her companion, due to her own ignorance and wishful thinking, she ended up in the ICU herself.

“Auntie, can you talk right now?”

Zhou Can looked at the frail woman in the bed, clearly much thinner than before, feeling a mix of emotions.

When the woman saw him, she nearly burst into tears.

“Dr. Zhou… if only I’d listened to your advice back then, I wouldn’t have ended up with one foot in the grave. My heart feels so heavy, I regret it so much, and my poor family…”

Her voice choked, tears streaming down her face.

Her daughter, who had taken time off work to care for her, quickly started wiping away the tears.

“Money comes and goes, but having your life is what really matters. You know, there’s a saying—what doesn’t kill you makes you stronger. I’m sure you’ll have a happy life ahead. Just look, your daughter is so filial, even taking leave to care for you here at the hospital.”

Zhou Can wasn’t the best at comforting people.

He could only offer a few simple words to reassure her.

“Let me check your vitals. If there’s anything making you uncomfortable, please tell us right away. And please don’t keep worrying about the past—if you keep a positive mood, you’ll recover and leave the hospital that much sooner. Holding on to stress and frustration is only going to slow down your recovery.”

He continued trying to lift her spirits.

There was nothing else for it; when a patient’s luck is this bad, a doctor needs to do whatever they can.

“Sob… I’ll listen to you this time. I won’t make the same mistakes again!”

Having learned her lesson the hard way, the elderly woman wouldn’t act stubborn anymore.

She even managed to stop crying and tried her best to calm down.

Her daughter took the chance to comfort her too.

“Mom, the doctor says you need to stay happy, so please don’t beat yourself up anymore!” She truly wanted her mother to let go and be happy again.

“And guess what? Dad was discharged two days ago and is resting up at home! He keeps saying, ‘It just doesn’t feel right when you’re not there.’ My sister-in-law and I joked that without you, he’s like he’s lost his soul.”

Hearing that, the woman actually smiled through her lingering regret.

“He never says those sweet things in front of me. Once I’m out, I’ll be sure to make him some chicken soup so he recovers faster.”

But then she suddenly remembered—and got nervous—since it was actually a dodgy batch of chicken soup that got her and her husband sick in the first place. She quickly asked, “Dr. Zhou, is it really safe to eat home-raised chicken?”

She’d been scared straight after that whole ‘tainted chicken soup’ incident.

“Absolutely! As long as the chicken is healthy and it’s thoroughly cooked, there’s no problem. Chicken is gentle and nourishing—after a serious illness, it’s great for helping the body recover.”

Zhou Can reassured her with a smile.

Standing nearby, Yu Xin couldn’t help but smile, too.

There was definitely an endearing side to this elderly lady.

Once Zhou Can finished checking her temperature, blood pressure, and heart rate, he also asked about her current symptoms.

“Auntie, all your vitals and symptoms look good. As long as you cooperate and stick with the treatment, you’ll be on your way out of here in no time.” Zhou Can’s words gave Yu Xin, the patient, and her family a big sense of relief.

Everyone’s faces lit up with joy.

Seeing a patient completely recover and leave the hospital is what every patient, family member, doctor, and nurse is after.

“Dr. Zhou, could you also double-check her prescriptions to see if anything needs tweaking?” Yu Xin explained, maybe worried Zhou Can would think she was being too nitpicky. “Director Shang told me and Duan Zifu that if we run into anything we’re not sure about with prescriptions, we should ask you.”

“Director Shang really gives me too much credit!”

Zhou Can offered a wry smile. He was, after all, just a trainee—not nearly as powerful as Director Shang seemed to think.

Luckily, his Pharmacological Reasoning had hit level four, so as long as it wasn’t a really complicated case, he could handle it.

He checked the prescriptions over carefully. Nothing was amiss.

“The prescriptions match her treatment and current symptoms—no changes needed. Still, keep a close eye out for any drug reactions. If anything weird pops up, call a superior right away.”

After being transferred out of the ICU, the elderly woman was still extremely frail.

Based on what he’d learned during his training in Critical Care, Zhou Can knew that patients like this needed extra attention.

As Zhou Can and Yu Xin chatted, Dr. Huang Liang—one of the senior residents under Dr. Zheng Hongtao—hurried into the ward.

He headed straight for Bed 67.

Looks like that one’s his patient.

When Huang Liang saw Zhou Can, he paused for a moment, looking a little uneasy.

Seven days ago, one of his patients with acute gastroenteritis almost died because Huang Liang misdiagnosed the issue and delayed treatment.

It was a dangerous situation.

If the patient had been sent to the Gastrointestinal Surgery Department just two or three hours later, they could have gone into shock—or worse.

Zhou Can spotted the signs of possible intestinal perforation in time, saving the patient—and, in a way, rescuing both Huang Liang and Dr. Zheng.

Yet their attitudes towards Zhou Can couldn’t be more different.

Now that Directors Zheng and Shang had reconciled, Dr. Zheng was actually very warm and friendly to Zhou Can.

Whenever they crossed paths, Dr. Zheng would even greet him with a big smile.

It showed Zheng Hongtao knew how to show gratitude.

“Morning!”

Huang Liang nodded at Zhou Can, greeting him.

“Morning.”

Zhou Can knew he was still bothered by what happened and didn’t take it personally.

In the Gastroenterology Department, Huang Liang was highly regarded, with a strong reputation among residents.

The fact that he made the effort to greet Zhou Can proved he was reasonable, just a little proud—so it made him act awkward around Zhou Can.

Really, he just didn’t want to look like he was on the losing end.

Still, Zhou Can had saved him, and seeing your benefactor face-to-face, it’s not like you can just pretend they’re a stranger.

Just then, an intern from Dr. Zheng’s team also rushed into the ward.

“Morning, Dr. Huang! I came as soon as I heard you’d arrived. This patient was admitted yesterday complaining of severe pain in the upper abdomen—sporadic at first, but more and more intense, going on for over ten hours. The ER already ordered blood work and an ultrasound and gave the patient antibiotics, but there’s been no improvement. That’s why they sent the patient over to our department.”

The on-duty intern quickly laid out the case.

Severe upper abdominal pain always triggers concern in a hospital.

At first, the ER probably thought it was just food poisoning or inflammation caused by something the patient ate and so tried antibiotics.

But now it’s clear this is more complicated than a regular stomach bug.

Huang Liang listened carefully and picked up the patient’s file.

His brow furrowed, growing more and more troubled.

It was obvious this wasn’t going to be an easy diagnosis.