Chapter 324: A Day in the Pediatrics Clinic: Trials, Tribulations, and Tenderness

Especially when it comes to chronic illnesses that aren’t all that serious.

Sometimes the families and patients barely want treatment at all, acting like it wouldn’t matter much either way.

This sanitation worker’s family is obviously not well off. If they had the money, they’d have treated the child already. They wouldn’t have waited for the mother to work outside for over a year just to scrape together enough for treatment before finally bringing him in.

The child’s father died in a car accident, and it’s likely they didn’t get any compensation.

Or maybe whatever money they received only covered emergency bills and funeral costs.

For a family this strapped for cash, they’ll drag out anything they can.

Today, I’ve already seen two patients, both of whom asked for me by name. That gave me a small sense of accomplishment.

You see, in the Pediatrics Department’s outpatient scheduling system, doctors are divided into five levels.

There are VIP specialists, renowned specialists, chief physicians, associate chief physicians, and regular clinics.

Unfortunately, I’m ranked at the very bottom—as a regular outpatient doctor.

But even so, I still get to bask in the spotlight with the attending physicians.

At Tuyu Hospital, it’s extremely tough for a resident doctor to get an outpatient slot. Only a handful of truly outstanding and lucky ones ever qualify. While it’s not an official rule, everyone knows you have to be at least at the attending level to apply for outpatient rights—this is an open secret around here.

Most senior residents who apply for outpatient privileges just get stuck in the queue.

Even some really talented resident doctors have to wait in line three or even four years and only get approved after being promoted to attending.

And even getting outpatient status doesn’t guarantee you’ll see patients.

The hospital assesses every doctor. If your outpatient care is lacking or your negative reviews pile up, well, that’s bad news. You technically keep your outpatient slot, but suddenly the registration button next to your name goes gray.

That’s basically the hospital’s way of ghosting you.

Rumor has it, if you go a full year without seeing patients, your name disappears. Though you can still find yourself in the system’s paperwork.

When they’ll let you back out onto the floor, nobody really knows. People say it’s one big mystery.

The only reason Zhou Can got fast-tracked and granted outpatient privileges early was not just because of his stellar performance but also because he’d appeared on the TV news.

Hospital executives always put profit first.

There’s no way they’d pass up a golden chance to attract patients and make money.

Maximizing gains—that’s one of the main reasons Director Zhu decided Zhou Can should get a special exemption.

And besides that, it’s a way to reward Zhou Can without handing out cash or giving him another promotion.

A win-win for everyone.

The child with macrodactyly had just left when someone else pushed open the door.

Zhou Can couldn’t help but smile a little. Maybe today wouldn’t be so rough after all.

Things seemed to be looking up.

“Doctor, please take a look at my child. We don’t know why he keeps getting a fever and always complains about chest pains.” The couple that walked in looked a mess. The man’s hair was wild and tangled like a bird’s nest, his jeans stained with dirt, and his white T-shirt looked downright disgusting.

His hands were actually rather fair, but his fingernails were long enough to rival an empress in a costume drama.

When he opened his mouth, he revealed a mouthful of yellow teeth.

The woman didn’t look much better—her hair was just thrown into a messy bun at the back of her head with stray hairs poking out everywhere, not that she cared. She wore a pair of dirty slippers on her feet that honestly drew attention.

Most women, no matter how rough they are about appearances, dress a bit tidier in public.

The two sat down immediately, without waiting for Zhou Can to say a word.

“How old is your child?”

As Zhou Can studied the child’s body and complexion, he asked.

“A little over three, maybe almost four?”

The man turned uncertainly to the woman.

A father who doesn’t even know how old his son is.

The woman rolled her eyes, thought about it seriously, and then nodded. “Three years and seven months, I think!”

“Does your child usually drink milk?”

“We never let him have that stuff!”

The man blurted out.

“What about regular meals? Does he eat well?”

Zhou Can continued his questions.

With no assistant or nurse on hand, he had to ask and jot down the history on his own.

“It’s alright, I guess. Most days he gets two meals, at least that’s covered.” Hearing this, Zhou Can felt a spike of anger. Still, one glance at the couple and he knew these weren’t people who would listen to reason. He decided not to fuss.

He just gently advised the child’s mother, “He’s still so young, two meals a day really isn’t enough. Look how skinny he is—he needs more to eat. If you can, cook dishes he likes, and aim for a balanced diet. Meat, fish, eggs, beans, fresh vegetables—there are plenty of ways to prepare them for kids.”

He directed these words mostly at the mother.

Normally, it’s the mom who handles most of the cooking.

“Alright, alright, we’ll be careful. But please, Doctor, just tell me what’s wrong with my son! We have other things to do,” the man snapped impatiently.

Zhou Can started measuring the boy’s temperature and other basic stats.

“How long has your child been running a fever?”

“More than two years. Seemed to start right after he stopped breastfeeding. When it’s bad, his face gets a little flush.”

“Has he been to a doctor before?”

“Who goes to the doctor unless it’s serious? Hospitals just eat money.”

The man grumbled under his breath.

Encountering parents like this honestly left Zhou Can speechless.

“Whoa, this is a serious fever—39.8 degrees, almost 40.” After taking his temperature, Zhou Can was really concerned.

From his experience, a child with a fever for this long, even a low one, likely has a serious condition.

For such a small kid to be hit with a severe illness—it tugged at his heart.

“If the fever wasn’t bad, why would we come see you? Even the cheapest appointment costs ten bucks. Doctors have it way too easy,” the man spat.

He’d almost been polite when he walked in.

But with a little more time, his true colors showed through.

“Hey kiddo, let Uncle see where your chest hurts!”

As Zhou Can lifted the boy’s shirt, he noticed something was really off about the kid’s abdomen.

He was downright skinny—his ribs stuck out everywhere.

Yet his belly was bloated, especially the upper part.

That area corresponds to the liver.

Given the boy’s long-standing chest pain, Zhou Can instinctively suspected something was wrong with his liver.

“My son hasn’t eaten in two days.”

The woman suddenly spoke up.

“Is he drinking water?”

Zhou Can felt his chest tighten. What kind of terrible mother was this? The child had gone two days with no food, run a fever for two years, and suffered constant chest pains yet never once saw a doctor.

And now she griped that a ten-yuan consultation was too expensive.

At a major hospital, even the cheapest pediatric slot goes for about that much. It’s the set minimum.

A subspecialty associate chief physician charges at least fifty. A standard clinic is half that, just twenty-five.

But for some reason, the pricier ones are always booked out, and nobody goes for the cheap ones. All the fifty-yuan spots are gone three days in advance.

“He’s drinking fine. On the way here, he saw another kid with yogurt and demanded some. We got him a bottle and he finished it all.”

She answered carelessly, not bothered in the least.

“Take him for a blood routine and a chest and abdominal ultrasound first.”

Zhou Can ordered two tests.

He’d wanted to order more, but seeing how these parents were, he didn’t dare. If he ordered too many, they might bolt.

“Where do we pay?”

“You can use the hospital’s app, or bring the receipt to the manual counter, or swipe your ID at one of the self-service machines,” Zhou Can explained patiently.

The man fiddled with his phone for a bit, then shouted like someone had just cut off his arm: “A hundred and twenty?! Why is it so expensive?”

Zhou Can could only shake his head—this was already dirt cheap.

He hadn’t even ordered a chest and abdominal CT scan yet.

After the ultrasound, if things looked bad, they’d definitely need a CT. That alone would cost a few hundred, and the man would probably have a meltdown.

The senior doctors in Pediatrics hadn’t lied—on his very first day seeing patients on his own, Zhou Can ran into two families like this.

“Every charge is set by higher-ups, and our hospital keeps every fee fully transparent. When the tests are done, bring your results back to me,” Zhou Can said.

He realized he just wasn’t cut out to deal with headache-inducing families like this.

He felt like his own life might just get shortened a few years.

“It’s way too expensive!”

The man cursed loudly as he tapped at his phone, but in the end, he paid up.

Still, the look on his face made it seem like he was being skinned alive.

“You little money-waster! You just cost your old man a hundred and thirty yuan, you know that?” After paying, the man rounded on his son.

That’s when his phone rang.

He checked the caller ID and suddenly got hyped.

“Hey! Need a fourth for mahjong? Okay, okay, I’m taking my kid to the hospital right now, I’ll be right there. Hang tight!” He hung up and looked at the woman. “I’m leaving. You take care of the exams—fees are paid.”

With that, he walked out without a backward glance.

The woman stomped and called after him, but he couldn’t care less.

In the end, she took the child for tests on her own, cursing at him as she went: “You little jinx… you troublemaker…”

Hearing this, Zhou Can’s jaw clenched. These two weren’t fit to be parents at all—absolutely infuriating.

He took a deep breath, trying to calm his anger.

Without a strong heart, you really can’t be a doctor.

Just then, another family entered with a patient.

“Dr. Zhou, my granddaughter has suddenly started vomiting after meals, has no energy, feels dizzy—can you please take a look?” The elderly woman who came in was impeccably dressed and her hair seemed freshly dyed.

Despite the deep crow’s feet and age spots on her face and the wrinkled skin on her hands, her hair was pure black and shining.

Not a single gray hair in sight.

Usually, people start getting gray hairs after thirty.

Especially nowadays, with stress, late nights, and endless anxieties, white hairs come easy.

Zhou Can glanced at the girl—seven or eight years old, face pale, lips colorless, eyes dull, like someone who hadn’t slept.

“Sweetie, do you remember when you started feeling bad?”

Zhou Can asked directly, making a point to talk with the patient.

There were many reasons—assessing her mental state, gauging whether her voice was hoarse or weak. With something like a respiratory infection, just talking can often trigger a cough.

Every little thing a doctor does can offer clues.

“Um… I think it started the morning before yesterday. I felt dizzy, got chills, felt worse at night, almost like motion sickness with tightness in my chest. By dinner, I felt so bad I threw up. After that, I felt a bit better, but didn’t want to eat. I just wanted to stay tucked in bed, and my grandma brought my meals over. I only took two bites before throwing up again.”

The girl explained her illness in detail.

“Later, Grandma ran out to get me some cold medicine. After I took it, I slept in bed. In the middle of the night, I remembered my homework wasn’t finished and tried to get up, but I just couldn’t. I started to get scared that maybe I’d die, and I cried. Grandma came over and sat with me the whole night…”

He felt lucky for this little girl—she had such a wonderful grandmother.

A hundred times better than those gambling parents from before.

“You’re even more attentive than most moms!” Zhou Can praised the elder with a smile.

“Sigh, what can you do? Her parents are always busy and traveling for work. I just retired, so I’m the one taking care of her. My granddaughter’s always been such a good kid, never causing trouble with homework or at school. If she finds something tasty, she won’t eat it herself—she’ll save it for me.”

As the elder spoke about her granddaughter, her face lit up.

Honestly, anyone would be as proud as she was with a child so thoughtful and sweet.

Even sick as she was, the little girl tried to get up in the middle of the night to finish her homework.

Truly heartwarming.

“Your granddaughter’s the gold standard for kids. I’m jealous!” Zhou Can joked, chatting easily with the family.

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He started checking her temperature, blood pressure, and respiratory rate.

He also listened closely for any abnormal breathing or sounds in her chest or abdomen.

Some patients breathe with a sound like fingernails scratching frosted glass, or odd noises from inside the chest.

All of these require attention.

To most people, a cold is just a minor illness. But to doctors, it’s a catch-all term, and some cases of the common cold can be just as deadly as leukemia or cancer.

Every year, the flu alone claims more than ninety thousand lives in China.

It sounds like nothing amid a population of 1.4 billion.

But for every family, ninety thousand lives lost to colds is ninety thousand families devastated.

Especially when it’s a child who dies—the impact can be crushing.

Zhou Can found the girl’s temperature to be 38.7 degrees—a solid fever, considered moderate.

Medically, fevers are split into four levels. Low is 37.1 to 38, moderate is 38.1 to 39, high fever is 39.1 to 41, and anything over 41 is ultra-high.

For high fevers, you have to protect the brain. Physical cooling is one common method.

That’s to stop the fever from damaging the brain.

Some parents, careless or just not worried, don’t handle their kid’s fever seriously enough. If the fever jumps past 41 and nothing is done, or if they just wait for morning, thinking things can wait—

That sort of thinking is dangerously wrong.

There have been smart, lively kids who, after one severe cold and fever, were left with brain damage.

It’s a heartbreaking loss.

Seasoned parents usually put a damp towel on the child’s forehead. It’s a common physical cooling method.

But you have to remember to change that towel now and then.

If you leave the same towel on too long, body heat will warm it up and it’ll stop working.

Honestly, the best bet is to bring the child in so doctors and nurses can take charge.

The girl’s symptoms—fever, vomiting, chills, dizziness, weakness—looked a lot like a cold. But over-the-counter meds hadn’t helped, which is why she was brought in.

It occured to Zhou Can that her symptoms might only resemble a cold. It could be something much worse.

The elder’s eyes looked a bit puffy and red, like she’d been crying.

Best guess: she’d worried herself sick over her granddaughter’s condition and had cried in secret.