Chapter 301: Refining Diagnosis: A Day of Growth and Challenge

Zhou Can completely understood Director Zhang’s diagnostic approach and intentions.

His pathology diagnostic skills were now on par with many of the experts present, reaching the level expected of an associate chief physician.

“Director Zhang, so you want the patient admitted, then put on a fasting regimen, restore fluids, suppress acid, and decompress the gastrointestinal tract to control the patient’s vomiting and diarrhea, right?”

Zhou Can asked her this to see if his own diagnostic abilities had truly reached an associate chief physician’s standard.

“Exactly!”

Director Zhang nodded, clearly pleased. Watching a junior quickly grow and comprehend her intentions brought her real joy.

“Do you know why we treat the symptoms and work to control the patient’s diarrhea and vomiting so early on?”

Director Zhang wanted to test Zhou Can’s diagnostic reasoning a step further.

A lot of rookie doctors blindly follow senior doctors when they order tests or run certain procedures, never really understanding why these are done.

That’s because their diagnostic skills aren’t on the same level as their superiors. They can’t see the deeper meaning behind those decisions.

It’s like playing chess. Someone might place a piece seemingly at random, but if you don’t have the skill, you can’t decipher what strategy they’re setting up.

You only realize their brilliance when the trap tightens and you’re completely cornered.

Zhou Can was still a resident in training. Expecting him to match a chief physician’s diagnostic thinking was a tall order.

In the past, he would’ve struggled to give a satisfactory answer.

Now, though, his pathology diagnostics were at the chief’s level—even if it was just associate chief, that’s still the real deal.

Associate chief and full chief are both considered senior titles.

It’s a key indicator of a physician’s professional skill.

After thinking for a moment, Zhou Can said calmly, “Your diagnostic strategy seems a lot like separating the fish eyes from the pearls.”

That’s actually an insult—calling something a “fish eye among pearls” means slipping something inferior among something precious. Was Zhou Can insulting Director Zhang?

Standing behind Director Zhang, Yang Chan—and right next to Zhou Can, Ji You—both started to sweat for Zhou Can.

Just the other day, Du Leng had publicly criticized Director Zhang and got chewed out.

He’s still sitting on the sidelines now.

Dr. Zhou usually has a quick wit, but today he had the nerve to insult Director Zhang? He was just asking for trouble.

Just as they thought Zhang Bihua would scold Zhou Can with a frosty look, she shocked everyone by breaking into a delighted smile.

He had just insulted her—so why was she so happy?

Yang Chan stood there, completely confused. What was happening today? Zhou Can usually has high emotional intelligence. He publicly insulted Director Zhang, yet she looked absolutely pleased.

It was too surreal.

“Separating fish eyes from pearls is the perfect metaphor. Go on!”

Even her smile didn’t express all her joy. Director Zhang had to praise Zhou Can again before she felt truly satisfied.

“This patient has a ton of symptoms—scattered, messy, involving multiple organs and systems. To force the real culprit to show itself, you’ve got to clear away all the distractions. If we get vomiting and diarrhea under control, then observe whether other symptoms change, we can zero in on the actual cause of illness.”

Zhou Can explained his thinking in his own words.

The family members, Yang Chan and the others listened with fascination.

None of them had seen a diagnostic method like this before. No wonder these doctors were called experts—they really had a lot of tricks up their sleeves.

“Absolutely right! Dr. Zhou, to show this level of diagnostic judgment already, you’ll go much farther than I ever could. I can’t even imagine what heights you’ll reach one day.”

Director Zhang complimented Zhou Can endlessly.

To become an outstanding young doctor, you need both talent and diligence—and a little luck and opportunity as well.

“Teacher, I still don’t really get it. Why call this a ‘separating fish eyes from pearls’ diagnosis?”

Yang Chan absentmindedly tucked her hair behind her ear.

They say long hair means short insight, but hers only brushes her shoulders—it’s not even that long.

Even after tying it in a ponytail, it barely touches her shoulders.

Still, with her ponytail, she looked capable and brimming with youth.

That natural, vibrant energy made her look full of youthful beauty.

“This patient has more than a dozen symptoms, making it really hard to pinpoint the true cause. The actual illness might be hidden or masked. It’s like searching for two fish eyes mixed in a bowl of pearls. If you try to pick out the fish eyes directly, it’s almost impossible—they’re hidden by the shine of the pearls, which distracts your vision.”

“So, you need a new approach. Don’t look for the fish eyes directly. Instead, pick out the pearls one by one. Once the pearls are all removed, what’s left must be the fish eyes. In reality, just removing a portion of the pearls makes the fish eyes pop out on their own.”

“By controlling the patient’s vomiting and diarrhea, any originally hidden cause will come to the surface. At that point, finding the culprit will be much easier.”

Director Zhang patiently instructed her beloved student.

She treated Yang Chan almost like a daughter, caring for her in every possible way.

“Dr. Zhou, Professor Zhang, after hearing your analysis, I feel so much more confident. We really came to the right place—I believe my son will get better here.”

Hearing all this, the boy’s father felt almost ashamed for ever doubting Zhou Can.

This young doctor was much more capable than he’d expected.

Even Professor Zhang couldn’t stop praising him.

Listening to their discussion about his son’s illness, the young Dr. Zhou never seemed out of his depth. His reasoning was sharp and clear, which made the father hopeful about his son’s recovery.

The patient was admitted for further observation after this, but that’s another matter.

…

The day’s diagnoses ended quickly.

On his first day running the clinic alone, Zhou Can gained a lot—especially in handling things on his own.

He saw a total of seven patients: one especially tricky case that needed hospitalization for further observation and diagnosis, and six others who either left after basic treatment or were admitted for surgery.

During these diagnoses, he also became aware of many of his own weaknesses.

Some were knowledge gaps, others were due to lack of experience.

Identifying these shortcomings was actually a great thing.

After this specialist clinic, he could focus his learning when he returned to Internal Medicine for residency training.

After work, the first thing Zhou Can did was check on the pregnant woman in the resuscitation room.

She was doing quite well, her vital signs much more stable.

Her blood pressure was up, and her spontaneous breathing had recovered significantly. Just listening to her breathing, he could tell her lung function was bouncing back fast.

People who exercise regularly recover way faster than those who don’t.

Zhou Can had noticed this often in his clinical work.

Two people with the same severity of pneumonia—one recovers in days with meds and proper care; the other, with poor constitution, just keeps getting worse until they end up in critical condition.

“Tonight, Ji You and I are on night shift again. We’ll keep watch one more night, and if everything goes well, we can consider removing the ventilator tomorrow.”

Seeing the pregnant patient steadily recover made Zhou Can genuinely happy.

“Ji You, are you up for another tough night?”

He turned to look at Ji You, who had followed him to the resuscitation room.

“No problem at all.”

She readily accepted the night shift.

After all, the last night shift with Zhou Can came with a late-night snack, which she thoroughly enjoyed.

…

The next day, after a preliminary assessment, Zhou Can decided she was ready to try breathing autonomously again without the ventilator.

But before removing it, there was one last thing to do: a femoral external fixation procedure.

Because when you take someone off a ventilator suddenly, their breathing might not go right back to normal.

If you remove the ventilator and jump straight into the femoral surgery, it would be a huge shock to her system—potentially dangerous, something called a ‘stress response’ in medical terms.

For example, if a patient needs surgery in two different spots, doctors usually recommend splitting it into two sessions for safety, not doing both at once.

Once Dr. Pang came for his shift, Zhou Can headed back to the hotel to freshen up and get breakfast.

While eating, he ran into Director Zhang down in the hotel’s restaurant.

He took the chance to consult with her about the pregnant woman’s treatment.

“Now that you’ve done the assessment and set the plan, the sooner the better. Let’s go to the resuscitation room and do the femoral fixation together, then check on her again during the lunch break. If everything looks normal, we can consider taking her off the ventilator and transferring her to a regular ward for further care.”

Director Zhang outlined a cautious and methodical treatment flow.

That’s just how chief physicians operate—steady and reliable.

“That’s a solid plan—it won’t affect our clinic schedule and gives her body the time to adjust.”

Zhou Can agreed wholeheartedly with Director Zhang’s procedure.

After breakfast, the two headed to the resuscitation room. Director Zhang first checked the patient’s condition and confirmed that the baby wouldn’t be in danger. Only then did they prepare for the next stage: external fixation surgery.

“Zhou, you handle the external fixation. I’ll take charge of the safety of the mother and fetus during the procedure.” Director Zhang had his back, freeing Zhou Can to focus fully on the task.

Zhou Can had reviewed this procedure for pregnant women many times before.

Now, he was ready to get hands on.

“Ji You, after I lift her right foot, support it and maintain the height and angle.” All the equipment for the external fixation had already been laid out.

This kind of procedure can only be done successfully with teamwork.

“No problem!”

Ji You never cut corners when it came to Zhou Can’s instructions.

After a couple of night shifts together, their friendship had gotten much closer.

“Chen Qingling, you’ll assist from the side and hand me the necessary tools.” He only had two nurses on hand and both were up for the task.

“Sure thing!”

Chen Qingling was an experienced nurse—clean, efficient, and highly skilled.

With everyone in place, Zhou Can began the procedure. He straightened the patient’s right leg and slowly lifted it, lining up the broken bone ends as best as possible with reference to the X-ray.

“Oww… mmm…”

The pregnant woman groaned in pain, and her blood pressure dropped instantly.

Zhou Can immediately stopped, worried—but her blood pressure soon bounced back. It was just the pain triggering the dip.

After more than an hour of effort, they finally got the external fixation done.

Zhou Can checked everything over—pleased, but not exactly perfect.

He couldn’t rate it as flawless just yet.

[You successfully performed a complex external fixation for a fracture. EXP +1. Bonus EXP +100.]

Scoring 101 experience points in one go for this skill left Zhou Can grinning from ear to ear.

Still, after getting the highest rewards before, a mere 100 points didn’t feel as thrilling as it used to.

It’s human nature—never satisfied for long.

An old poem once described human greed perfectly.

“We run all day just for a meal; once full, we want better clothes. When dressed and fed, we wish for a pretty wife. With wife and child, we curse our lack of land. Finally, buying up a vast estate, we envy those with horses and boats.”

The poem makes it clear—human desires are endless.

It’s just like the story of the fisherman and the goldfish: once a wish is granted, even bigger ones follow. Human greed is never truly satisfied.

Even with all the wealth, power, and beauty in the world, it’s not enough. The next thing people want is immortality.

Many ancient emperors proved this point again and again.

There were too many emperors chasing after elixirs of immortality to even count.

After Zhou Can finished the external fixation, Director Zhang didn’t leave immediately.

She monitored both the fetal heart rate and all the mother’s vital signs closely.

Half an hour later, with no problems detected, she finally relaxed a little.

“All seems well for now. Dr. Pang, you’ll be in charge of monitoring this patient—make sure to stay vigilant and don’t let any accidents happen.”

Director Zhang instructed her with utmost seriousness.

Xinxiang Maternity and Child Hospital had already decided to use this patient’s case as a promotional example. In a sense, the groundwork had been laid; now it just needed to be maintained.

At this key moment, neither Director Zhang nor the hospital wanted any surprises.

The hospital saw the value in using high-profile cases like this one to build their reputation. The pregnant woman’s situation was perfect for publicity and had already been marked as a highlight.

Director Zhang’s specialist clinic team also needed solid performance for this trip.

It had already been three days—this was day four.

Every complicated case, from diagnosis through treatment, was hard fought. She wasn’t about to let any slip-ups happen now.

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“Don’t worry. I’ll take good care of the patient!”

While Dr. Pang answered firmly, she glanced at Zhou Can a little nervously.

The incident from two days ago still made her anxious. She was afraid Zhou Can would complain about her to Director Zhang.

Luckily, things stayed quiet on Director Zhang’s end.

It seemed Zhou Can had helped her keep it under wraps.

Naturally, Dr. Pang felt grateful.

“Zhou, your clinic performance yesterday was great. Do the same today.” After assigning Dr. Pang her duties, Director Zhang looked at Zhou Can.

“No problem at all.”

Zhou Can agreed without hesitation.

Starting something new is always toughest—now that he’d made that first step, his fear was gone. Instead, he was actually looking forward to the challenge.

This was genuine independent practice.

It would significantly improve his diagnostic abilities and lay a solid foundation for his career.

After leaving the resuscitation room, Director Zhang took Zhou Can and Yang Chan to do rounds in the ward.

All the patients the team had admitted were in the same ward, making it easier for Tuyu Hospital’s doctors to follow up. Day-to-day management was handled by Xinxiang Maternity and Child Hospital’s nurses and physicians.

“Hello, Professor Zhang!”

Several patients greeted Zhang Bihua as they passed.

Just seeing that, you knew how famous Zhang Bihua was. Many of these patients had been diagnosed and admitted personally by her.

“Hello, Professor Zhang! Hi, Dr. Zhou!”

At the sixth bed, a family member greeted them with a broad smile.

Zhou Can recognized him at once—it was the husband of the diabetic patient with excessive thirst and urination. Judging by his cheerful face, had his wife taken a turn for the better?

Without thinking, he glanced at the patient in bed and saw that she really did look much healthier.

“How’s your wife’s illness? Has she improved?” Director Zhang asked.

“Yes, definitely! The day you and Dr. Zhou suggested radiotherapy for her, we were terrified and almost refused. But then doctors from Xinxiang Maternity and Child Hospital explained everything and took us to see other patients having the treatment.”

“After talking with those who’d gone through it, I found out that some people’s illness was brought under control with radiotherapy, and some even recovered and were discharged. My wife and I figured, well, either way, it’s worth a try. To our surprise, the same day as her first treatment, her symptoms started improving.”

The patient’s husband was positively beaming as he spoke.

For families, nothing is more joyful than seeing their loved ones improve after treatment.