Chapter 302: Silent Struggles in the Clinic

Zhou Can and Director Zhang were both genuinely pleased to see the family member finally come around and let his wife accept radiation therapy.

Many ordinary people are terrified of the words ‘radiation therapy’—just hearing them can feel like a death sentence.

What most don’t realize is that, to this day, radiation therapy remains one of the most effective weapons against cancer.

Chemotherapy actually has the most intense side effects. While it targets cancer cells with powerful drugs, it also takes quite a toll on healthy cells. It’s a classic case of winning a battle but suffering heavy losses.

“After starting radiation therapy, this patient went from urinating over a hundred times a day down to just about thirty. Even her daily water intake dropped to around 7,000 milliliters.”

The attending doctor was standing nearby, reporting the patient’s progress to Director Zhang.

It looked like Zhou Can’s diagnosis was spot-on. The true culprit behind this woman’s illness was a hypothalamic-pituitary disorder.

Just one round of radiation had brought about dramatic improvements—pretty remarkable.

If she could stick with the treatments for a full course, Zhou Can was certain she’d see satisfying results.

Director Zhang nodded in approval after listening to the doctor’s report.

She personally reviewed the latest nursing records: vital signs, urination frequency, time intervals. Zhou Can watched from the side, quietly learning from Zhang’s thorough and meticulous approach.

Doing rounds wasn’t just a routine to check off the list—Director Zhang showed how it should really be done.

“I see she’s getting better all around. We need to keep focusing on two things: controlling blood sugar and continuing radiation therapy.” Director Zhang gave her guidance.

They moved on to check other patients.

When they reached the little boy who’d eaten the live fish, Zhou Can felt a flicker of hope.

He’d already started fasting, was getting fluids, and had his stomach and intestines relieved of pressure.

“Dr. Zhou, Director Zhang!”

The family member spotted Zhou Can and Director Zhang and greeted them with obvious warmth.

Right now, only the boy’s father was at his bedside.

Yesterday, when the whole family came in together, Zhou Can suspected they either had property in the provincial capital or a relative to stay with.

“How is your son doing today?”

“He’s a little better. The vomiting and diarrhea are both much improved.”

The boy’s father looked relieved, happy to see the treatment was working.

Most people aren’t experts. As long as symptoms ease up, they feel hopeful for a cure—even if the methods are just temporary measures to buy time.

It’s like a car running on the auxiliary gas tank. You can keep going, but unless you refill the main tank, the problem isn’t really fixed.

To truly cure an illness, you have to uncover the real cause.

These days, a lot of hospitals opt for ambiguous treatment plans. When the cause isn’t clear, they simply treat the symptoms, trying to keep things from getting worse and letting patients live with their illness long term.

This kind of lazy, shortcut-thinking has sadly become the clinical norm for much of the medical world.

There’s an old saying: living poorly is still better than dying well.

So, using drugs or other treatments to ease pain and prolong life is sometimes the best compromise.

At the very least, everyone in the system accepts this sort of model.

‘Save the patient first, cure the disease later’—that was the first rule Zhou Can learned in clinical practice.

“His temperature has dropped a bit, the highest was 37.1 degrees.”

Zhou Can flipped through the hospital records. Compared to yesterday’s 38 degrees, it was a clear decrease.

Just then, the sound of someone tearing open a plastic bag came from the bed nearby.

The boy’s eyes darted in that direction.

A family member was feeding the patient some crackers.

That little boy had gone more than twelve hours without eating or drinking—he had to be starving. No wonder he looked envious when someone else got to eat.

He swallowed hard, trying not to stare.

“Cough, cough…”

It seemed he choked on his own saliva, suddenly launching into a fierce coughing fit. His father quickly soothed him with gentle pats on the back.

Normally, people only choke when drinking water.

Choking on your own saliva is pretty rare.

Though, sometimes accidents just happen.

When the boy finally stopped coughing, his face was bright red from all the struggling.

Ordinarily, Zhou Can wouldn’t have paid much mind to that.

But a moment later, the little boy started coughing violently all over again.

This time, Zhou Can became a lot more alert.

After the boy calmed down, Zhou Can asked, “Has your son always been this easy to choke?”

“No, it just started this morning. I even told him to be extra careful swallowing his saliva,” his father replied in a helpless—and puzzled—tone.

How could a healthy boy suddenly start choking on his own saliva?

Director Zhang noticed too and fell into thoughtful silence.

“Could the coughing be related to the stomach decompression?” Yang Chan blurted out.

“That’s possible.”

Zhang Bihua nodded slightly.

“The boy’s digestive, urinary, heart, and lung systems are all affected. There aren’t many diseases that attack so many areas at once. Since cancer’s been ruled out, we’re only left with a handful. He tested negative for ANA, so lupus looked unlikely.”

Director Zhang’s diagnosis matched Zhou Can’s—they were both facing a tricky puzzle.

But Zhou Can stared at the child for a while before daring to suggest, “Do you think his lupus might be hidden? If we don’t treat the negative ANA test as the gold standard, his disease course and symptoms really fit systemic lupus erythematosus.”

Sometimes the courage of youth leads to bold new ideas.

New doctors like Zhou Can aren’t as cautious as veterans like Director Zhang.

He didn’t hesitate to question even hard-and-fast rules.

“Teacher, I think this child’s symptoms really do resemble lupus. When I was interning in Pediatrics, I saw a six-year-old girl—a sweet, thoughtful child. She started with flu-like symptoms, but after treatments at several hospitals, kept getting worse. New symptoms cropped up constantly.”

“She was eventually diagnosed with lupus—but in her case, the ANA test came back positive.”

Yang Chan backed up Zhou Can’s line of thinking.

She figured it was at least worth a shot.

“You young people, so bold and fearless! Diagnosing a disease isn’t something you can afford to do lightly. Still, it’s good that you’re willing to challenge gold standards, to question and hypothesize. Let’s do this—run the ANA test for him again, both at Xinxiang Maternity and Child Hospital and at Tuyu Main Hospital.”

Director Zhang clearly had her reasons for this decision.

There were things she couldn’t say in front of the Xinxiang hospital staff.

Tuyu Hospital is already known as the province’s top lab. Their biochemical testing and sample analysis are far beyond other hospitals.

ANA—antinuclear antibody spectrum—detects certain autoantibodies in blood serum. If levels test strongly positive, it usually points to connective tissue disease.

This isn’t a particularly high-end test, but the patient’s ANA readings had always come back negative.

Sending another blood sample to Tuyu Hospital’s lab was a wise move.

It would help rule out missed diagnoses caused by inferior equipment or less skilled staff.

The family now had a lot of faith in Zhou Can and Director Zhang, and readily agreed to all their suggestions.

Over the last three days, they’d admitted a total of eleven patients, including two requiring surgery. Zhou Can eyed them with envy. Ever since he’d transferred to Internal Medicine, his opportunities for surgical training had dwindled.

One surgery involved removing uterine fibroids, the other was for a chest granuloma—both were quite challenging procedures.

If Zhou Can were allowed to perform them himself, it would be invaluable for his development as a surgeon.

His surgical skills needed constant practice—otherwise, time away would lead to decline.

Director Zhang hinted that both surgeries would probably happen that evening, with herself at the helm—giving up her own time so the patients wouldn’t miss a daytime consultation.

After rounds, Zhou Can and Director Zhang headed back to the outpatient lobby for clinic hours.

Even though Zhou Can’s debut at the clinic yesterday had gone well—impressing patients and achieving good results—building up his reputation proved way harder than he imagined.

His return to the clinic today felt almost like starting from scratch.

His desk was quiet and deserted—no patients stopping by.

Compared to yesterday, there were even more sick people crowding the lobby.

There were crowds of patients, but hardly anyone signed up to see him. Every new doctor faces this awkward stage.

Some young doctors rely on the hospital’s brand—its reputation and traffic attract patients even if no one knows their individual skills.

Most patients aren’t necessarily chasing a specific doctor—they come for the prestige of a renowned hospital.

When the expert appointments sell out, they’ll settle for a regular slot.

But Zhou Can’s situation was different.

Xinxiang Maternity and Child Hospital was reeling from a crisis of trust and couldn’t vouch for his reputation.

Even being part of Tuyu Hospital’s respected team, with the Specialist Team backing him, he was still so young—patients just had too many options.

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Naturally, people weren’t ready to rely on a doctor who looked inexperienced. It only made sense.

Du Leng, however, had it much easier.

His foreign medical degree was the best calling card. Most patients didn’t know the details, but seeing ‘studied abroad’ boosted their confidence.

Loads of people were lining up to see Du Leng.

Who says a diploma doesn’t matter?

A degree isn’t just a ticket into the job—it’s a golden badge on your resume. It lets you start from a higher rung than most.

So, Zhou Can spent a lonely day at clinic.

Yesterday he saw seven patients; today only two stopped by—and both seemed skeptical and dissatisfied.

One patient stormed out cursing after Zhou Can ordered a CT scan. The other just had a common cold, but his parents treated him like fragile glass, calling him ‘baby’ and ‘sweetie’ until Zhou Can got goosebumps.

He forced himself to finish the exam, wrote the prescription, then watched as they left and went straight to see Director Dai for a second opinion.

Today was the most discouraging day Zhou Can had ever had.

He had the skill but was invisible without reputation or credentials. No one believed or acknowledged him.

At dinner, Ji You thoughtfully brought him a meal.

“Dr. Zhou, I hope the food’s to your taste?”

“If it’s from you, even plain rice tastes great. These dishes are really delicious! Thanks!” Zhou Can couldn’t quite get used to being treated like royalty.

“Haha, as long as you like it. I never imagined the serious Dr. Zhou would be so good at charming girls!” She shot him a shy glance and quickly ducked her head back to her food.

At first, Zhou Can was a little slow to catch on.

But he’d been in relationships before—he recognized that look. For a moment, it seemed like Ji You’s heart might be stirring.

Thinking back on what he said, he pinched himself.

One careless comment had clearly caused a misunderstanding.

“Haha, my sweet talk is only a survival skill. When I was courting my current girlfriend, I had lots of practice.” He didn’t want any misunderstanding growing further.

The only way was to be upfront and clear things up.

Letting Ji You know he had a girlfriend was simply the best solution.

He remembered how hurt Qiao Yu looked when she found out he was taken—the expression never quite left his mind.

He’d learned his lesson: at the first sign of trouble, be clear and shut down any misplaced hopes.

“Keke~!”

She laughed, covering her mouth, her shoulders shaking.

After learning Zhou Can was taken, there was a touch of disappointment deep in her eyes.

But she only had a bit of a crush—her heart wasn’t truly invested—so no real harm done, just a little letdown.

“A guy as outstanding as you? Of course you’d have a girlfriend! People say love helps you mature—for you, that means learning how to make a girl smile!”

She teased Zhou Can.

“I had no choice but to practice. Otherwise, my girlfriend might’ve been whisked away.” Zhou Can scratched his nose.

“With how amazing you are, no one else stands a chance! Still, it doesn’t hurt to polish your silver tongue—a big edge in any competition. All life on Earth is racing to evolve and we humans are evolving fastest. Our progress is in our minds and how we think, not just our bodies.”

She thought very highly of Zhou Can.

“I didn’t know you were so witty, Ji—you’re beautiful, talented, and genuine. You’re the real star here.”

Chatting with her gradually lifted Zhou Can’s mood after a gloomy day.

The two of them ate and talked, one meal making up for all the disappointment.

“I could tell you weren’t yourself after work today. Feeling better now?” Near the end of dinner, Ji You asked quietly.

“With a gorgeous woman like you cheering me up, how could I still be upset? You really are observant.” Zhou Can felt genuinely moved. Being shown care like this was happiness.

“Of course I understand. Sitting beside you in clinic, I could feel almost everything you felt! Honestly, if you have real talent, you’ll shine sooner or later. You just need time—your skill’s there, you only lack recognition and opportunities. It’s only a matter of time before people line up to see you.”

She encouraged Zhou Can warmly.