Chapter 280: A Common Cold, A Lingering Mystery

What started as an ordinary cold became a nightmare for this young, beautiful girl.

It left her sick for a full two years.

With modern medicine, even a bad cold isn’t considered serious. Buy some over-the-counter medicine and you’ll be better in no time.

But when she was seventeen, this girl fell ill and never truly recovered.

Seventeen or eighteen is when you’re supposed to be at your healthiest—full of energy and resilience.

Zhou Can realized right away that something had gone wrong with her immune system. Only a decline or deficiency could’ve let a simple cold topple her body’s defenses.

Almost all difficult cases have one thing in common—the patient has seen many doctors at different hospitals yet still finds no relief.

Most complex illnesses start out looking deceptively minor. They’re masters of disguise, showing up as a low-grade fever, mild pain, or slight discomfort—nothing enough to raise alarms.

They’re like stubborn weeds: the more you cut them down, the more they spread. Eventually, they turn into full-blown disasters that break the patient down and even steal their life.

Diseases that are dangerous from the start are scary, sure, but at least their symptoms are obvious, which makes them easier to diagnose.

Treatment might still be tough, though.

But the real challenge with tough cases is finding the true cause. Once you do, it’s like you’ve found the enemy’s weak spot—maybe all it takes is a cheap little box of medicine to cure everything.

Many patients who’ve gone through every checkup with general doctors—racked up bills for pricey drugs, tried everything without getting better—know this well.

Then, someone recommends seeing a specialist.

Surprisingly, the expert doesn’t ask for any new tests. After a careful examination, they just prescribe a simple medicine that costs next to nothing.

The patient can’t help but wonder if this expert really knows what they’re doing.

Maybe they’re a pretend-expert after all?

But following the instructions out of curiosity, the patient takes the meds, and after a week, something miraculous happens.

They’re already starting to feel better.

Two weeks later, the stubborn illness that’s tormented them for ages is finally gone. From then on, the patient won’t stop singing the praises of seeing a real specialist.

They just regret not booking the expert appointment sooner.

All that money wasted on useless medicine and pointless exams, serving as practice dummies for regular doctors—just thinking about it is enough to make anyone upset.

That patient was lucky, no doubt.

They happened to meet a specialist who was skilled at treating their particular disease.

Otherwise, who knows how it might’ve ended up.

Plenty of people have had minor problems made worse by the wrong treatment.

A girl whose cold dragged on for two years, never getting better—it sounds unbelievable.

Zhou Can picked up her medical records and looked them over carefully.

Senior doctors love it when young physicians are eager to learn.

Her erythrocyte sedimentation rate was 39mm in the first hour. ALT clocked in at 170u/l, AST at 137u/l, and alkaline phosphatase was a staggering 320u/l…

After reading the lab report, Zhou Can immediately suspected trouble with her lymphatic system.

At the first hospital, she was given azithromycin for infection control, but it barely made a difference.

Later, another hospital performed a bone marrow biopsy and an ultrasound.

Honestly, seeing so many tests being repeated, it’s surprising her family didn’t lose their temper.

The bone marrow results showed active proliferation.

Abdominal ultrasound revealed polyps in her gallbladder.

Her spleen was enlarged.

There was also lymph node swelling near her hepatic portal.

Sure enough, Zhou Can’s instincts were right—her lymphatic system was in trouble.

He kept reading through all the other hospital’s test results.

After the hepatic lymph node swelling was found, the outside specialist had her undergo an ultrasound on her lymph nodes.

Tests showed that her neck, armpits, and groin all had enlarged lymph nodes.

Swollen lymph nodes in so many places usually mean the entire body is affected.

That was even worse than Zhou Can had feared.

If it were just overexertion, the swelling would probably only show up in the neck area.

There are two basic types of cold in Chinese medicine—one from chills, the other from heat.

The vanguard of ‘hot wind’ colds is a combination of heat in the body and an external invasion, described as a double syndrome.

The outside specialist wasn’t clueless. Picking up on the lymph node swelling, they performed a lymph node biopsy in her groin.

Results showed reactive hyperplasia. Immunohistochemistry confirmed an increase of both T and B cells, as well as tissue cells.

That pretty much locked in the possibility of a viral infection.

The outside specialist prescribed hepatoprotective and antiviral medication.

That’s standard treatment—a common approach in medicine.

Afterward, the patient improved—briefly. In less than ten days, she started running a fever again. This time it was a high fever over 40°C and came with a cough.

Her family rushed her back to the hospital, finding the same specialist once again.

Since treatment had worked before, the family trusted that specialist completely.

Upon taking her on again, the doctor immediately ordered a blood test.

Results showed her lymphocytes were up to 47%. The bone marrow looked normal, AST was at 43u/l—AST means aspartate aminotransferase.

If they’re checking that, they always check ALP too—alkaline phosphatase hit 141u/l.

Next came blood and sputum cultures, probably because the specialist still suspected an infection or virus.

After no real progress, the specialist was at a loss and finally ordered an abdominal CT scan.

Chances are, last time they only did an ultrasound of her abdomen and weren’t satisfied it told the whole story.

They wanted clearer imaging on the affected area.

So they went ahead and did the CT scan.

The scan showed her liver was enlarged, she had fatty liver, her spleen was still a bit big, and there was a low-density lesion on the left adnexa.

Seeing those results, Zhou Can couldn’t help but sigh. Take away all these high-tech diagnostic machines, and even a seasoned specialist would be taken back to square one.

Take this girl, for example. Last time they only ran an abdominal ultrasound and completely missed her fatty liver and ovarian lesion.

The CT showed a low-density mass by the left adnexa—that’s really just a tumor or cyst on her ovary.

This time, not wanting to be caught off guard, the specialist had her undergo a liver biopsy for pathology.

Results showed mild swelling of her liver cells, some small areas of fatty change, and scattered points of necrosis.

There was mild dilation of the portal area and a notable infiltration of lymphocytes.

The lobular interface was slightly damaged.

And yet more lymphocyte infiltration showed up in the liver sinuses.

Eventually, the specialist diagnosed her with chronic hepatitis, fatty liver, and gallbladder polyps.

She was put through another round of hepatoprotective and antiviral therapy.

She stayed in the hospital for nearly four months, only being released after some improvement.

But the whole time, her fever never went away.

She went from having a high fever to a lingering low one—she was still running a mild temperature when discharged.

After release, she kept taking liver-protecting medication.

Back home, she would often have a fever at night—sometimes it climbed above 38°C.

Then, about half a year later, out of the blue, both her eyes turned bloodshot, her vision blurred, her right ear buzzed, her hearing worsened, and even her nose started getting blocked.

Her mom, seeing all this, felt hopeless. Her daughter’s condition hadn’t improved at all—in fact, it was worse than ever.

Worried that sticking with that same specialist would just make things worse, she took her daughter to a different hospital this time.

But after three days of tests, those doctors still couldn’t figure out the cause.

With no answers there, the girl’s mother had no choice but to return to the outside specialist.

This time, the specialist spoke very tactfully. He admitted that even after decades of practice, he’d never seen an illness this tricky. With her health declining, he advised them to try Tuyu Hospital or another major medical center.

It was like a joke you’d see in some old comedy sketch—the kind where someone throws in the towel and passes the problem along.

After doing everything he could, the expert still couldn’t cure this girl. If he kept at it and something went wrong, he’d only get a bad reputation.

So he told her family to go ‘trouble’ the specialists at other hospitals instead.

Truth is, a lot of doctors have done the same thing.

Her mom planned to book an expert appointment at Tuyu Hospital, but those slots were impossible to get.

Then she heard that many Tuyu Hospital specialists would be seeing patients at Xinxiang Maternity and Child Hospital, so she rushed over with her daughter.

At first, seeing Professor Zhang Bihua from the Obstetrics Department and a doctoral graduate from a prestigious overseas university, she felt hopeful—maybe they’d come to the right place after all.

But then Du Leng ordered a ton of tests backed up with loads of medical theory.

It turned out the overseas-educated doctor looked impressive, but was all show and no substance.

Great theoretical knowledge, but almost useless in clinical diagnosis.

“Director Zhang, can you cure my daughter?”

The girl’s mom had heard of Zhang Bihua’s reputation. By now, though, she’d nearly lost all hope for her daughter.

“Please don’t worry. No matter how difficult an illness is, if we identify the real cause, we can target it and cure it. We have plenty of experts here, plus the strong support of Tuyu Hospital behind us. Even if we can’t pinpoint the problem today, we’ll ask senior specialists to consult and do everything we can to help your daughter.”

Zhang Bihua gently offered comfort to the mother, who was on the verge of collapse.

“Yang Chan, please do a physical exam on the patient.”

Since the patient was a young woman, it was better for a female doctor to examine her.

Yang Chan carried out the examination.

Her temperature was 38°C—definitely a fever. Pulse was at 115 bpm. Blood pressure 110/80 mmHg. Zhou Can could feel a soft, movable lymph node in her right groin. There was mild redness in both eyes’ conjunctiva, but no swelling or yellowing.

Her throat was a bit red, the left tonsil was swollen and covered with pus, but her gag reflex was present.

She felt weak in both legs and was unsteady when standing. Both sides of her feet and her soles were hurting, too.

She also had some hearing loss.

“Because your daughter can’t stand steadily and has weak legs, we’ll need to run an electromyography to check her peripheral nerves, hearing, and sympathetic nerves in limbs. As for the ear and throat symptoms, Dr. Du has already ordered a sinus CT. The scan shows inflammation in her right ethmoid and both maxillary sinuses. Head MRI reveals thickened mucosa in her sinuses and inflammation in both mastoids…”

After reviewing all the test results and getting Yang Chan’s exam report, Director Zhang gave a further diagnostic opinion.

Frankly, Du Leng had already had the patient do pretty much every test she could.

That included a sinus CT and brain MRI and so on.

After speaking, Director Zhang looked over to the other two specialists.

“Director Jiang, Director Shi, do you have anything to add?”

This case had dragged on for over two years, wreaking havoc throughout the patient’s body. It was extremely complicated.

Zhou Can couldn’t help but feel that if this were an average family, they’d have given up and just tried some herbal medicine at home instead.

After all, not every household can afford sky-high medical bills.

Most families give up on further treatment at big hospitals after one failure, convinced that nothing will change elsewhere.

So they leave it to fate.

Directors Jiang and Shi both shook their heads.

The case was so thorny it left them both at a loss—neither could offer anything constructive.

“Dr. Zhou, what about you? Do you have any suggestions?”

Zhang Bihua respected Zhou Can’s opinion, considering his impressive performance with the previous two difficult cases.

“Could I examine her neck?”

Zhou Can asked an unexpected question.

He’d watched carefully while Yang Chan examined the patient earlier.

Still, even if he wanted to check her neck himself, he had to consider gender boundaries—one wrong step, and it could be awkward.

“Of course. There’s nothing to hide when it comes to healing. Dr. Zhou, go ahead and check my daughter.”

The family had been quietly observing over at Director Du Leng’s side too.

Zhou Can’s sharp insight during the overweight woman’s diagnosis had impressed the family so much, even outshining the specialists, that their trust in him was sky-high.

In their hearts, they had a lot of faith in Zhou Can.

“Thank you for your trust and understanding!”

Zhou Can walked over to the girl, his expression turning serious.

“If you feel any pain as I examine you, just let me know right away,” he told her.

He explained to the girl.

“Alright.”

Her voice was airy and soft, clearly lacking energy.

After his reminder, Zhou Can gently touched her slender neck. Her skin was delicate, making it even easier to feel for any growths under the surface.

He moved his hand from the side of her neck to the larynx and surrounding areas.

“Ah… that hurts, it hurts…”

The girl suddenly cried out in pain.

Zhou Can nodded, as if he’d expected this reaction.

“Try to bear it for a moment. I’ll be as gentle as I can. I want to check the size of the tumor, and see if there are any others nearby.”

What he’d actually found was in her throat.

After a thorough exam, he didn’t find any additional growths or unusual findings.

“Dr. Zhou suspects a tumor in her throat?”

Director Zhang asked, astonished.

The patient and her mom found even more respect for this young doctor’s skills.

“There should be a tumor inside her throat, probably not large. I recommend pinpointing it and doing a biopsy. It feels very likely to be lymphoma.”

Zhou Can’s tone was confident and certain.

Lymphomas can be extremely hard to detect, especially when it’s a lymphangioma. The tiny lymphatic vessels can be less than a millimeter wide—sometimes even an MRI can’t pick them up.

Director Zhang looked at the family.

“Would you be open to having a throat tumor exam as well?”

“Absolutely, of course! Dr. Zhou is incredible—he figured out that my daughter might have a tumor in her throat without even using any instruments.”

The family praised Zhou Can.

As far as she was concerned, as long as they found the cause, no amount of tests would feel excessive.

For well-off families, the worry isn’t about money but whether the illness can be cured.

The wealthier people get, the more aware they are of risk. Their insurance portfolios are usually rock solid.

Even with a major illness, between basic health insurance and commercial coverage, they’re rarely out of pocket.

But for most working families, every penny goes to keep food on the table—there’s nothing left for expensive private health plans.

So when something catastrophic happens, it usually means selling the house or car to pay medical bills.

Many are plunged into poverty by illness.

The patient went off for more tests.

“Dr. Zhou’s clinical skill and diagnostic ability are seriously next level!”

Gao Jian said to Zhou Can with a bittersweet smile.

It goes without saying—he had lost out completely with these tough cases.

While Zhou Can kept racking up big wins and important diagnoses, Gao Jian—despite nearly two years’ residency at Tuyu Hospital as a top student from Imperial Capital Medical University—hadn’t even gotten a chance to speak.

It wasn’t that he didn’t want to, he just didn’t have the ability to offer anything useful.

“Dr. Gao, you don’t have to praise me that much. Honestly, my only flaw is that I can’t handle too many compliments.” Zhou Can joked, making everyone chuckle.

“C’mon, Xiao Gao, let’s go. Dr. Zhou’s skills are hard-earned—real learning happens when you diagnose patients yourself,” Director Jiang reminded him.

Director Jiang glanced meaningfully toward Du Leng’s table nearby, which had gone from bustling to quiet.