Chapter 326: A Day of Diagnosis and Dilemmas

After spotting so many café-au-lait spots on the patient’s body, Zhou Can was almost certain of the diagnosis.

Actually, this disease can be detected through an eye exam too.

With a slit-lamp, an ophthalmologist can see small, yellow-brown nodules shaped like millet on the iris.

Picking up the patient’s ultrasound report, Zhou Can noted the presence of a subcutaneous mass.

For this illness, neurofibromas often appear along the peripheral nerves at the affected area.

Without timely treatment, it can spread even further.

That’s also why the fingers nearby have started to develop lesions too.

Right now, there’s no miracle drug for treating giant digit neurofibromatosis. The best approach is surgery, paired with medications. The main goal is to give the patient a good quality of life and reduce the risk of relapse.

And of course, to lower the chances of complications.

At this stage, there’s still no cure for the disease.

Zhou Can’s treatment plan was clear. Considering the family’s financial struggles—the father died in a car accident, the grandmother works sanitation, and the mother is out working odd jobs—

he wanted to save them as much on medical costs as possible and keep the tumors from coming back.

But first and foremost, he had to do everything he could to restore the function of the patient’s hand. The kid was still so young. Every time his right hand was exposed, it looked almost monstrous—just thinking of it was enough to leave lasting scars on a child’s heart.

He’d inevitably end up excluded and bullied at school too.

The primary goal right now was to operate so the boy’s right hand could look and function normally again.

After talking things through with the boy’s grandmother, Zhou arranged for the child to be admitted for surgery.

Surgical treatment included reducing soft tissue, growth plate fusion, bone resection, partial finger amputation, carpal tunnel decompression… It might look like just two affected fingers, but the reality was far more complicated.

It also called for serious surgical skill.

But on that front, there was no need to worry.

Tuyu’s surgery department was one of the best in the province, with several teams more than capable of handling surgeries at this level.

Around eleven in the morning, the little boy who’d had a fever for over two years and chest pain—who hadn’t eaten for two days—returned after his bloodwork and ultrasound.

His mother handed Zhou Can the test results, constantly glancing at her phone.

Anyone who didn’t know better would think she was anxious to get to work.

But seeing this, Zhou could barely hold back his anger. The boy’s father was a hopeless gambler, and his mother was no better.

The kid only ate two meals a day. If his mother had even a shred of responsibility, he wouldn’t be in this mess.

“The bloodwork shows his white blood cell count and neutrophil count are both way up, and he’s anemic. His hemoglobin is low,” Zhou reported, frowning slightly as he read the results.

A persistent fever and high white blood cell count—put together, these usually mean there’s inflammation or infection in the body.

On top of that, the boy had been complaining of chest pain for some time, but the pain was actually in his upper abdomen, right where the liver is.

When Zhou checked the ultrasound results, he was shocked.

“Your son’s liver probably has an abscess or even a tumor! And things are looking very serious!”

No wonder the kid kept saying his chest hurt.

The area of fluid darkness in the liver was massive. Zhou figured the odds leaned heavily toward a liver abscess—not a tumor.

Ultrasound is really accurate for diagnosing the size and range of an abscess.

Parents like these make him want to take off his shoe and slap them across the face.

If they’d brought him in when the fever first started, it never would’ve gotten this bad.

“I know it’s serious. So, doctor, how do we treat it?”

The woman just looked totally indifferent.

Maybe she thought Zhou was just trying to scare her.

“My advice is to do a liver puncture first and draw some fluid for further testing. Once we know exactly what’s going on, we’ll decide on the next steps.”

That was Zhou’s recommendation.

Right now, a liver abscess was their best guess—but not confirmed.

They didn’t even know exactly what disease they were dealing with.

“Didn’t you already find out what’s wrong? More tests? You’ve seen the kid’s father’s attitude. There’s no way he’s handing over a pile of money for treatment.”

As soon as she heard this, the woman was instantly upset.

Hard to tell if she was just heartless or didn’t realize how critical her son’s condition was.

“If his father won’t pay, you’re still his parent. You can handle his treatment!”

Zhou stared straight at her.

The boy looked up at his mother with desperate eyes.

“I really don’t have any money. How am I supposed to treat him?”

She felt her son’s gaze on her and, for the first time, seemed to grow a conscience.

There was a hint more sincerity now.

“Don’t you have a job?”

Zhou asked, puzzled.

“Nope. His father and I play cards and mahjong all day. If we win, we order takeout. If not, we just make some noodles at home or something.”

Her answer left Zhou Can genuinely stunned.

He never knew someone could actually live like this.

“You two don’t work, have no savings… What’ll you do if something big comes up, like now with your son’s illness? Treatment’s going to cost at least ten thousand. If you can’t pay, are you planning to just give up on your kid?”

Zhou was used to meeting the positive side of society through his job.

His friends and colleagues were at least doctors or nurses—decent jobs, steady income, decent social status. His parents, Mr. Li, Mr. Cui, his girlfriend Su Qianqian—all were part of the middle or upper-middle class.

The only ‘underprivileged’ people he ever met were usually patients.

Like the sanitation-worker grandma who brought her grandson in for surgery, or the young dad bringing in his kid for windblown-hand deformity—they might not have much, but they still worked hard and refused to sink to the bottom.

But these two gambling addicts slept on the card table and never worked. Zhou couldn’t even fathom it.

Worst of all, it was their child who suffered for it.

“What did you say? My son’s treatment will cost over ten thousand?”

The price seemed to finally shock her.

Ten thousand might be just a few weeks’ pay for some people, but for folks who gamble for a living, that was a fortune.

“At least ten thousand. If you’d brought him in when the fever started, maybe three thousand would’ve been enough.”

Zhou said sternly.

“Let me call his father.”

Her phone, at least, looked pricey—probably cost two or three thousand yuan.

Everyone has their own way of living, Zhou mused. People like her lived day to day, with no plan for tomorrow.

“Hey, honey, the doctor says treating our son will cost at least ten thousand. What do we do?”

“I’m in the middle of a game! Even if you sell me, I’m not worth that much! Figure it out yourself!”

“I don’t have any money!”

“If you don’t have cash, what makes you think I do? I just spent a hundred and twenty on tests for that little money pit this morning. I’ve gotta win it back. That’s it, I’m hanging up.”

“Hey, hello…”

She slumped, staring at her phone after the call ended.

“Doctor, you saw what his dad is like. I told you, he won’t do anything. I’ve got just over three hundred on me. Can’t you give us some medicine? I’ll take my son home and treat him myself.”

At least in that moment, she seemed almost human—willing to spend every cent she had on medicine for her son.

But the boy’s condition was already so severe, he’d definitely need a puncture or even surgery to drain the abscess. Three hundred wouldn’t even scratch the surface.

Zhou could only look troubled.

“Your son’s illness isn’t something that pills alone can cure. He needs a puncture to drain it, and we haven’t even identified the exact cause—so I can’t prescribe anything yet. And we can’t afford any more delay, or his life is at risk.”

All Zhou could do was try his best to persuade her.

“Ten thousand—I have no idea where I’d get that kind of money!” she said helplessly.

“You’re his mother. There’s no way you’d just watch your own son left untreated, right? Try borrowing from relatives and friends—save his life first. Once he’s better, you can find work to pay back the debt. If you have a child, you’re responsible for raising him—that’s what the law says too.”

Zhou had no other choice, so he offered any solution he could.

No matter what, saving the child’s life had to come first.

“All right. I’ll make some calls and see what I can do.”

Mother and son left the room together.

Even so, Zhou still worried after seeing her attitude.

Hard to imagine: parents so cold, they’d let their kid die over ten thousand in treatment fees.

This was beyond Zhou’s usual experience—he knew he had to report it.

Looking at how small the child was, he just couldn’t bear it.

This was a human life!

He immediately called Director Tang, who led the Pediatrics Department. Reporting it to her was the safest choice.

The phone was quickly answered.

“Hello, Director Tang, this is Zhou Can!”

“Hello! Dr. Zhou, it’s your first day seeing patients—did something come up?”

Director Tang’s voice was gentle, low, and reassuring.

“Yes, I’ve just treated a patient…” Zhou briefly explained the situation.

“In these cases, calling the police doesn’t help. Give me the family’s address and the parents’ identification info. We’ll contact the local Women’s Federation or neighborhood committee and let them handle it.”

Director Tang had much more experience with this sort of thing.

If parents refuse to treat their child, doctors usually try to persuade the grandparents. If that fails, the neighborhood committee or social organizations step in—sometimes, that’s the only way to ensure the child gets care.

It would never work for the hospital or the doctor to pay these bills.

Doctors have their own families to support and only so much they can do. Even someone as wealthy as Zhou—worth tens of millions—would go broke in a year if he personally paid for every patient in trouble.

Not to mention, it would be foolish.

Just then, the exam room door opened and another patient walked in.

“Another patient just came in, so I’ll have to let you go!” Zhou said to Director Tang.

“All right, take care of your work. If that boy’s parents still won’t treat him, just send me their names, phone numbers, and address. I’ll take it from there.”

With that, she hung up.

Zhou put away his phone and looked up at the patient’s family.

It was the grandmother who’d brought in her granddaughter.

“Dr. Zhou, we’ve finished the tests. Can you look over the results for us?”

Taking the report, Zhou motioned for the girl and her grandmother to sit and rest. He was sure the eight-year-old didn’t just have a cold.

But he’d have to take things step by step, carefully diagnosing what was actually wrong.

One thing was clear: whatever it was, it had to be something rare and serious.

He started by checking her complete blood count.

Her white blood cell count was just 1.7 x 10⁹/L, way below normal.

For reference, normal is 4–10 x 10⁹/L in adults, 5–12 x 10⁹/L in children.

This girl was only eight, clearly in the children’s range.

So honestly, she should have at least 5 x 10⁹/L to be considered healthy.

But she was down to 1.7—scarily low.

The percentages of neutrophils and lymphocytes were just below average, but still within normal range.

But when Zhou glanced at her platelets, he saw only 37.5 x 10⁹/L.

Again, that was far under normal levels.

Such a drastic drop in both white blood cells and platelets always meant something serious—not a simple cold.

Zhou grew even more certain of his working diagnosis.

But what could it be?

He’d also ordered a urinalysis.

Looking at that, he saw her urine protein was 4+.

The girl’s grandmother watched nervously as the young doctor checked each report, his face growing more serious with every result. Her heart tightened with every glance.

“Dr. Zhou, what’s wrong with my granddaughter? Is it serious?”

She sounded urgent.

“Based on these results, I can tell you it’s definitely not just a cold. Her white blood cell and platelet counts are far too low, and her urine test is worrying—protein at 4+.”

Zhou almost added that it was most likely a major illness.

But seeing the old lady already turning pale, he didn’t dare say more.

If he scared the family into a panic before there was a diagnosis, it would be a disaster.

Many retirees had worked desk jobs.

Their bodies often came with underlying problems, and as they aged, they couldn’t handle too much shock.

Hypertension and heart disease—any big scare could set those off.

“Dr. Zhou, I’m begging you… please save my granddaughter! Her parents can’t be here, and they’ve left her to me. If anything happened, what would I do?”

The grandmother was shrewd. Even if Zhou hadn’t spelled it out, she already guessed things weren’t looking good.

“Please don’t worry, I promise we’ll do everything we can for her. For now, we only have the bloodwork and urinalysis; there are clear problems, but we can’t make a firm diagnosis yet. We’ll need your help for some more tests—biochemistry panels, for example.”

Zhou noticed the old woman’s hands shaking as she pulled out a tissue, wiping sweat from her brow.

Her face was growing paler by the second, enough to worry anyone.

Zhou was nervous the elderly woman might collapse—then things would really get complicated.

“Of course we’ll do the extra tests. Do you need to take X-rays?”

“No need for imagery. Just a blood draw—sending the samples to the lab for specific analyses, like LDH and AST. Are you feeling unwell anywhere?”

Zhou asked, concerned.

Right now, he wished he had a nurse by his side.

If the old woman fainted right there, it would be a nightmare.

“I just feel weak all over, my head hurts, and my chest feels tight, like something heavy is pressing on me!” She had to prop herself up on the table, clearly not doing well.

Chest tightness after an emotional shock, especially in the elderly, put Zhou on high alert.

He couldn’t believe his luck today—seemed like everything he dreaded was happening.

Shortness of breath and chest tightness often come right before a heart attack or cardiac event.

And with her headache on top of that, if high blood pressure flared up now, it’d be even worse.

“You don’t have a history of coronary disease or hypertension, do you?”

Zhou asked anxiously.

“I do—high blood pressure. I’ve always taken medication and it’s well controlled. Still, I really don’t feel right, everything’s spinning…”

As she spoke, her body slumped forward onto the desk. She was gasping for air.

“Grandma! Grandma…!” Seeing her collapse, the little girl burst into tears.

Zhou jumped up to open the clinic door, calling out to the nurse outside: “Emergency! We’ve got a family member who may have fainted from shock—call for more doctors and nurses to help, quick!”

“Ah! I’ll sound the alarm!”

The nurse panicked, but dashed off.

Zhou rushed back to check the grandmother.

First, he made sure her airway was clear—then he checked her blood pressure.

Strangely, her blood pressure was normal, but her pulse was racing—the same as the little girl’s.

She said she didn’t have heart disease or high blood pressure, so it definitely wasn’t a hypertension attack.