Chapter 43: A Critical Diagnosis in the Brainstem

Director Yin from the Neurology Department also reviewed the images and nodded slightly, saying, “It is indeed a cerebral arterial aneurysm. It’s small, but it has just invaded the brainstem.”

After speaking, he handed the ultrasound images over to Director Tan for further review.

“Director Tan, what do you think?”

“I agree with your diagnosis. However, as for how to eliminate this brain aneurysm, we’ll need to consult with the Surgical Department on a treatment plan.”

Director Tan’s gaze shifted toward Director Xie from the Surgical Department.

Only through the combined efforts of the Internal Medicine and Surgical Departments can we overcome this formidable illness.

While the two key departments deliberated on the surgical plan, Zhou Can felt that he couldn’t wait any longer.

The brainstem is the central hub of the nervous system—a veritable no-go zone.

Surgery in this area is extremely risky.

Even the most experienced neurosurgeons tread with extreme caution; a tiny mistake could lead to irreversible disaster.

If the patient had truly taken the wrong medication, leading to uncontrolled blood pressure, then proper treatment to lower it might even cause the aneurysm to disappear on its own.

At least, that’s what Zhou Can believed.

He had read about similar cases in medical texts.

This pregnant woman’s intracranial pressure was far above normal, making the appearance of a ‘temporary arterial aneurysm’ very plausible—a condition closely linked to over fifteen years of hypertension.

Long-term high blood pressure inevitably leads to vascular atherosclerosis.

“Director Lou, is it possible to run a specialized blood and urine test on the patient?”

Zhou Can gathered his courage to ask.

“Aren’t the diagnostic results already out? Stop meddling. Consider this a valuable learning experience—just observe from the sidelines.”

Director Lou dismissed Zhou Can’s suggestion outright.

The Emergency Department, already embarrassed by its failure to diagnose the pregnant woman’s condition, had little room left to insist.

Now that the Internal and Surgical Departments had reached a consensus and were discussing the surgical plan, the Emergency Department’s role was simply to assist—not to create further complications.

Departments may compete, but they must not undermine one another; the bigger picture must always come first.

Watching the unconscious pregnant woman, Zhou Can sighed quietly to himself.

As only a resident in training, just being allowed to observe high-level consultations was a rare honor. His opinions, however, were not taken seriously.

After several department heads from Internal Medicine and Surgery conferred, they decided on a craniotomy for the patient.

However, because the lesion was in such an unusual location, the surgery was extremely risky—even Wu Baihe’s ‘Peak Scalpel’ did not guarantee success.

A botched operation could mean death for both the patient and the doctor.

The Surgical Department’s leading surgeon, known by his moniker ‘Peak Scalpel,’ wore a deep frown, bluntly admitting that the success rate was below fifty percent.

Zhou Can decided to take another risk.

“Dr. Xu, I suspect that the pregnant woman’s brain aneurysm might be an illusion. Operating on her without absolute certainty is too dangerous. The child in her womb is the sole surviving blood of a fallen narcotics officer. I request a specialized blood test to check if she has ingested any medication that could elevate her blood pressure.”

With no other options left,

Zhou Can had to reluctantly approach Dr. Xu.

If Dr. Xu still disagreed, then the patient’s fate would be left entirely to chance.

After all, his position was so low that if his superiors wouldn’t listen to him, he was utterly helpless.

“This…”

Dr. Xu was equally conflicted.

In this consultation, his status wasn’t much higher than Zhou Can’s.

“Director Xie, Director Tan, could we please request a specialized blood test for the patient?” Dr. Xu, meeting Zhou Can’s imploring eyes, finally mustered the courage to ask the two lead physicians.

“Old Xu, Old Xu, Zhou Can is just acting recklessly. Why are you joining in? The blood test has already been done—there’s no need for another. The priority now is to schedule the surgery immediately.”

Director Xie flatly refused.

Director Tan stayed silent, essentially endorsing Director Xie’s view.

Berated, Dr. Xu gave Zhou Can a helpless glance and said nothing further.

Yang Chan observed all of this silently.

“Teacher, I’ve known Zhou Can for five years and have never seen him this anxious. If he wasn’t so sure of his diagnosis, he wouldn’t have twice requested a specialized blood test for the patient. Please, help him, won’t you?”

At that moment, she resorted to an adorable plea with Director Zhang Bihua.

Only a handful of influential voices were present at the meeting.

A simple nod from Director Zhang Bihua would silence any opposition from Directors Xie and Tan.

Zhou Can’s hope, which had been nearly extinguished, was rekindled.

In this critical moment, it was an old classmate’s loyalty that made a difference.

“Little Zhou, explain your diagnostic reasoning!”

Director Zhang Bihua fixed her gaze on Zhou Can.

Moved by Yang Chan’s earnest plea, she granted him a chance—time was too precious when saving a life.

“Thank you, Director Zhang, for this opportunity. Everyone, please take a look at the patient’s eyebrows.”

Zhou Can clung to his final lifeline.

The others were puzzled. What did the patient’s eyebrows have to do with her condition?

“Oh dear, her eyebrow makeup is a complete mess—she even got the tails crooked,” Nurse Ye Tingting exclaimed.

The doctors stepped forward to take a closer look. Sure enough, it was true.

“Hypertensive disorders in pregnancy can lead to retinal changes, blurred vision, or even blindness. Clearly, the patient is already suffering from poor vision. She was on her way to visit her parents, so she would have paid extra attention to her appearance. The fact that her makeup is so off indicates that she hasn’t noticed her vision deteriorating.”

Zhou Can then explained his diagnosis.

Director Zhang Bihua nodded approvingly and said, “Go on.”

The other doctors began to take Zhou Can’s opinion seriously.

Even Director Yin, who had initially dismissed him, listened intently. His gaze toward Zhou Can shifted from condescension to respect.

From initial disregard, his attitude transformed entirely.

“We know that patients with chronic hypertension must take their blood pressure medication daily. Before leaving to visit her parents, she would have taken her pills. With her vision blurred, it’s possible she grabbed the wrong medication by mistake—mistaking it for her regular pills. The timeline, from when she left home to collapsing in a taxi, fits a scenario where a medication error caused her blood pressure to spike suddenly.”

Director Zhang Bihua nodded again, conceding that such a possibility did exist.

“I once read in a renowned surgical text about a similar case. The patient, with a long history of hypertension, had a confrontation that sent her blood pressure soaring. She collapsed, and upon admission, was found to have a cerebral arterial aneurysm compressing her nerves. Due to the high risk of surgery, the hospital opted for conservative treatment by lowering her blood pressure. Remarkably, as her blood pressure fell, the aneurysm gradually disappeared.”

Zhou Can shared the case he had seen in his readings.

“I too have read about a similar case in a surgical journal. These sudden aneurysms, which resemble ‘balloons,’ often occur in patients with over a decade of hypertension. When blood pressure surges, the affected vessels can balloon out, forming a temporary arterial aneurysm.”

Director Yin, an acknowledged expert in Neurology, demonstrated that his expertise extended even into surgical literature.

“Immediately order a specialized blood test for the patient and postpone the surgery for now. Although her condition is critical, with Director Zhang’s effective measures to preserve the fetus, she isn’t in imminent danger.”

Director Yin now addressed Zhou Can as ‘Dr. Zhou’—a marked change from when he dismissed him as just an inexperienced youngster.

This was the respect Zhou Can had earned through his competence.

It was his persistence that averted a potential misdiagnosis.

In doing so, he saved the reputations of all the doctors present.

“I fully support this. Avoiding surgery is best, given the extreme risks. Honestly, if we were to operate, I wouldn’t even be fifty percent confident of success.”

Wu Baihe was well aware of the patient’s significance.

If she were to die in his care—even with a signed risk waiver from the family—he feared he would never escape blame.

Rising from an intern to the esteemed status of the neurosurgical ‘Peak Scalpel’ was no small feat.

Several chief physicians had already agreed to conduct a specialized blood test, after which the procedure would become straightforward.

Blood would be drawn immediately and sent off for urgent analysis.

While awaiting the test results, the senior doctors’ attitude toward Zhou Can underwent a dramatic turnaround.

“Director Lou, when selecting team members yesterday, you had the sharpest eye,” remarked Director Tan with a hint of envy.

“Haha, you also chose outstanding candidates! That kid Zhou Can truly has a gift for medicine. The Emergency Department desperately needs a successor like him.” Director Lou laughed heartily, though he worried that the influential department heads might one day steal his thunder.

After praising Zhou Can, he made sure to stress how vital the young doctor was to the Emergency Department.

In contrast, the foreign doctor Du Leng now felt rather awkward.

There was every chance he would soon be proven wrong by Zhou Can.

To hide his embarrassment, he could only clutch the patient’s chart and scrutinize it meticulously—as if he hoped to catch even the slightest error.