Chapter 292: A Battle of Wits in the Emergency Room

“Dr. Zhou, could you share the basis for your diagnosis?”

Yang Chan still found it hard to believe.

The patient’s symptoms clearly pointed to rectal cancer, and in previous discussions, the experts agreed that gastrointestinal cancer was likely. She had accepted those conclusions.

After all, one of the main features of digestive tract tumors is their tendency to metastasize downward.

For instance, if esophageal cancer isn’t caught in time, it can easily spread, and patients may then develop stomach or intestinal cancer.

The ovaries aren’t part of the digestive system and are tucked away in the female pelvis, a bit behind the anterior superior iliac spine.

Though they’re near the rectum, their pathologies don’t usually connect.

Even if the primary tumor was in the ovaries, the uterus would be the most likely site for metastasis.

“Hmm… The diagnosis in this case mainly relied on a combination of symptoms and clinical experience. The test results actually took a supporting role. For example, the patient reported abdominal bloating for nearly five months, plus difficulty defecating and abdominal fluid buildup. All these symptoms suggest that one or more organs have developed lesions.”

“With abdominal distention and difficult bowel movements, after ruling out a colon lesion, I used clinical experience for two-way deduction. A tumor in the rectum can cause difficulty passing stool and bloating. But when I learned there were signet ring cells in the abdominal fluid, I immediately suspected more than just the rectum was involved—or at least, the stomach had also developed lesions.”

“Sure enough, further examination confirmed a tumor at the greater curvature of the stomach. If we follow standard logic, it would make sense for gastric cancer to metastasize to the rectum, leading to rectal cancer. But if you look closely, you’ll notice the rectal tumor is huge, while the stomach tumor is much smaller. Plus, the patient only started having stomach discomfort in the last month or so. So I took the leap and concluded the stomach tumor developed after the rectal one.”

Zhou Can broke down the diagnostic reasoning for her step by step.

The other experts nodded along in agreement.

Yang Chan looked at him, eyes alight with admiration.

It never occurred to her that a diagnosis could be reasoned out in reverse like this.

“Gastric cancer metastasizing to the rectum, that’s pretty common. Rectal cancer metastasizing to the stomach is much rarer. So I believe the stomach tumor is not the primary site. As for why I suspect an ovarian tumor, it comes down to my clinical experience and a few subtle pathological clues. After age forty, women face a much higher risk for ovarian disease, and I’ve handled three cases of ovarian cancer metastasis myself. That’s why I made this bold call.”

Zhou Can continued explaining his diagnostic process.

Even the family members nodded along with the experts and Yang Chan, showing their approval.

“Professor, do you think an abdominopelvic CT scan or imaging could detect an ovarian tumor in this patient?” Now that Yang Chan understood Zhou Can’s reasoning, she had no doubt about the thought process—though she was still concerned about the ultimate result.

“The ovary is a gonad, and when it develops a tumor, it’s even harder to diagnose than pancreatic cancer. A CT scan might catch the lesion, but sometimes it doesn’t show up at all. MRI isn’t infallible either—missed and false diagnoses happen. The gold standard is to take suspicious tissue samples for pathology. Dr. Zhou is right—surgery to extract a bit of tissue for biopsy is the surest way.”

When even someone with Zhang Bihua’s wealth of diagnostic experience says standard tests are unreliable,

it’s clear just how tough it is to catch ovarian cancer.

After communicating with the patient and family, they agreed to a surgical biopsy.

The team at Xinxiang Maternity and Child Hospital could handle the procedure; there was no need for the Tuyu experts to do it themselves.

If they couldn’t perform even that kind of surgery, they wouldn’t be considered a top-tier specialty hospital.

With Zhou Can performing so brilliantly time and again, his standing with the other experts was rising quickly. Those who’d known little about him were now seeing him in a whole new light.

The people at Xinxiang Maternity and Child Hospital were keeping a close eye on this resident physician with such outstanding skill.

Even the reporters had caught on that this young doctor was no ordinary talent—far beyond that so-called international PhD. Eyes, intentionally or not, kept drifting Zhou Can’s way.

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Reporter Mu Qing was the first to realize Zhou Can was a big catch.

At the moment, she was racking her brains over how to quickly establish a good relationship with Zhou Can and nab that interview.

Unfortunately, the beauty and flirtatious charm that never failed her elsewhere didn’t seem to have any effect on him.

It left her rather frustrated.

Zhou Can didn’t pay any attention to the admiring or envious stares. Once he’d finished with the diagnosis, he returned to the resuscitation room.

The pregnant woman, now five months along, weighed heavily on his mind.

The first six hours after her vitals stabilized were crucial.

“Dr. Pang, is everything steady with her?”

Zhou Can asked politely.

He wasn’t close with Dr. Pang, so the tone was nothing like the easy banter he had with Deputy Director Shi.

“It’s fine.”

Dr. Pang’s tone was a little frosty, her face lacking any hint of a smile.

Zhou Can had long noticed something was off with her mood.

Earlier that morning during the resuscitation, she’d been part of the crisis response team and should have stayed at his side as an assistant—but didn’t. She did her own thing, making it clear she had no intention of following his lead.

When the pregnant woman’s condition stabilized, Dr. Pang didn’t stick around with Deputy Director Shi and Zhou Can. Instead she left with Director Zhang and the others.

Later, when Director Zhang was faced with a rectal cancer case that was hard to diagnose, Zhou Can was urgently called in for a consultation.

It took Deputy Director Shi’s intervention to get Dr. Pang back in the room.

When she finally arrived, her demeanor was icy, just as it was now.

She wasn’t blatantly hostile to Zhou Can, though.

Just cold, indifferent, and barely willing to engage.

Though Zhou Can found it irritating, he didn’t press the issue.

She was an attending physician in obstetrics—a senior compared to him, just a lowly resident.

“If there’s nothing else, I’ll take my leave.”

With that, Dr. Pang tossed out the words and marched out of the resuscitation room.

The two nurses watching exchanged odd looks but didn’t say a word.

Nurses never get involved in fights between doctors.

Their positions are just too different—there’s simply no way to intervene.

“Wait. Deputy Director Shi is seeing patients in the outpatient hall, so I’m the only doctor here watching over the pregnant woman. If anything critical happens, I’ll be caught off guard. Dr. Pang, unless you have urgent business elsewhere, I’d like you to stay and help watch over this patient with me. The first six hours after a fat embolism are extremely dangerous—anything could happen.”

Having spent months in critical care, Zhou Can knew just how fragile life really is.

Sometimes people are here one moment, gone the next.

“Outpatient needs my help too! Things seem settled here. Dr. Zhou, you’re clearly the best at handling everything anyway—I’m sure you can take care of it just fine.”

Even with Zhou Can’s request, she turned him down.

And her words held a sting, like she was mocking him.

Zhou Can wasn’t oblivious. He knew exactly why she was acting this way.

It all boiled down to her not being chosen as deputy team leader. Instead, a rookie with lower rank—him—got the role, and now she, a senior, had to take orders. Of course she was upset.

“If you insist on going to outpatient, who takes responsibility if something happens to this pregnant woman?”

The smile faded from Zhou Can’s face.

If she didn’t respect courtesy, he’d have no choice but to leverage his authority.

Just because you have high emotional intelligence doesn’t mean you’ll never ruffle feathers.

When it comes to saving lives, everyone on the medical team has to work in sync. If Dr. Pang isn’t put in line, and she acts out in an emergency, the consequences could be dire.

“Ha! Dr. Zhou, if you’re in charge here, why should anyone else take the blame? Besides, so long as a doctor does their duty in an emergency, what responsibility could there be?”

Dr. Pang’s smile was all surface—her eyes didn’t budge.

“With this patient relying on a ventilator to survive, if disaster strikes, can you really handle it all alone, Dr. Pang?”

Zhou Can stared at her, voice firm.

This time, his tone shifted—an order from a superior to a subordinate.

It might rub Dr. Pang the wrong way, but there was no helping that.

If she was satisfied, Zhou Can would have to let things slide.

“If your absence leads to a failed rescue and the higher-ups investigate, who do you think will be held responsible? That’s all I’ll say. Dr. Pang, if you don’t care about your future, leave if you want. But if you step a single foot out of this room without my approval as deputy team leader, I’ll show you what it means to be a doctor.”

Zhou Can didn’t mince words—he applied real pressure.

He was determined to see if she’d really dare.

There’s a saying: the wicked can’t overpower the righteous—but only if the righteous are brave enough.

If you’re soft, the bullies will only take advantage.

Now, in front of two Tuyu nurses and colleagues from Xinxiang Maternity and Child Hospital, Dr. Pang was red-faced with anger, her gaze sharp as knives.

Zhou Can just stared back, his face cool and steady.

Their eyes locked, the room thick with tension.

“If you’ve got the nerve, just go—don’t hesitate!”

Zhou Can could already see the hint of retreat in her eyes.

For a woman nearly forty, a stable job means everything. From him, she saw confidence and fearlessness.

“And if I walk out, what can you do?”

She was still reluctant to back down, probing for any weakness.

After clashing so publicly with Zhou Can today, embarrassment was inevitable.

But if she won, she’d satisfy her pride and save face.

So she tested him.

“As deputy team leader, I’m ordering you to stay here on standby for this pregnant patient. If you insist on leaving, that counts as insubordination. I’ll report your attitude to Director Zhang right away, and she’ll decide how to handle you. You may think you have connections at Tuyu Hospital, but that’s not enough. You could even lose your job over this.”

Zhou Can laid it out plain as day.

He wasn’t bluffing—he really had the clout.

At nearly forty, an attending physician had limited prospects. Next to a prodigy like Zhou Can, the gap was huge.

“Can’t I even go to the restroom? Haha, I was only joking with you, Dr. Zhou!”

After a few seconds torn between pride and fear, she forced a smile and instantly backed down.

Just as Zhou Can expected—she wasn’t willing to gamble.

Especially since she had no ground to stand on.

“Of course you can use the restroom. I know you were just kidding, Dr. Pang. I didn’t take it seriously.”

Zhou Can could adjust his tone to suit any situation.

Just like that, the room’s tension faded and everything seemed back to normal.

But of course, that was just on the surface.

Making up is easy. Pretending nothing ever happened—that’s hard.

After that clash, Dr. Pang probably wouldn’t forget Zhou Can anytime soon.

But so what?

When Zhou Can started out in the emergency department, he’d put Dr. Lu in his place, and eventually, Dr. Lu came around and repaired the relationship.

Now, Zhou Can was countless times stronger than before. If Dr. Pang ever wanted to mend fences, she’d do it even faster.

For adults, pride means very little—interests matter far more.

Angering Zhou Can could affect her prospects—promotions, awards, even her eligibility for senior rank at Tuyu Hospital. Could she really bear that pressure?

After Dr. Pang left, the older nurse, Chen Qingling, kept quiet.

The younger nurse, Ji You, lowered her voice and whispered, “Dr. Zhou, you’re amazing. You really put her in her place. She’s usually a total tyrant in obstetrics.” Before she could say more, Chen Qingling nudged her.

Talking about colleagues behind their backs is the worst taboo at work.

It’s a surefire way to invite trouble.

Ji You glanced at Chen Qingling, caught the warning look, and clammed up.

Ji You’s words made it clear—Dr. Pang was a bully in her department.

“Aren’t you worried she’ll hear you badmouthing her?”

Zhou Can asked with a teasing grin.

“Not at all! Doctors and nurses are separate systems—she can’t do anything to me.”

She sounded bold, but there was still a bit of fear in her eyes.

Attending doctors definitely have the power to make a nurse’s life hard if they want to.

Not long after, Dr. Pang returned from her ‘restroom’ trip.

Her face looked much better than before.

No trace now of that hostile, petty attitude.

A forty-year-old woman knows when to hold back and when to let go—a lot tougher than a twenty-year-old girl.

……

Around three in the afternoon, Zhou Can’s phone rang.

This time, it was a call from Director Zhang Bihua herself.

“Hello, Director Zhang, what can I do for you?”

Zhou Can greeted her respectfully.

When Dr. Pang realized it was Director Zhang, she immediately pricked up her ears to listen in.

It was clear she was a little on edge.

Afraid Zhou Can might complain about her.

“Zhou, how are things over there?”

“The pregnant patient’s vitals are stable, but her blood pressure is still a bit unstable. I’m not letting my guard down,” Zhou Can answered honestly.

“Can you spare a few minutes? The diabetic patient who was drinking excessively yesterday is doing better after treatment, but that’s just temporary. To cure her, we’ll need a panel of experts to review her case and find the root cause.”

Director Zhang had seen firsthand how capable Zhou Can was—no wonder she relied on him so much.

“Do you need me right now?”

Zhou Can asked.

“Yes, the family is in the outpatient hall. They told me the patient is doing better and are very relieved, but also mentioned they’re struggling financially. They’re hoping we can use this opportunity to completely cure her.”

Director Zhang is a genuinely kind person—just like most chief physicians. She truly cares about her patients.