Chapter 469: False Alarms and Real Answers

After finishing his rounds Zhou Can still couldn’t help but worry about how Dr. Tang Fei was doing.

After causing a bit of trouble it’s only right to check in on the other person.

His relationship with Dr. Tang Fei was mostly that of superior and subordinate—they were friendly, but nowhere near as close as he was with Director Xueyan.

At least he had a perfectly good reason to call.

He was about to head into the emergency operating room to start his day. He could ask how the child he diagnosed yesterday was doing.

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He made the call and it picked up almost instantly.

So things didn’t seem too bad after all.

“Sorry to bother you so early, Dr. Tang!”

Zhou Can jumped in first.

“It’s no bother at all, I’m already at the hospital for work.” She actually sounded in pretty good spirits.

Zhou Can braced himself and cautiously asked, “Sorry about causing issues at home yesterday. If you need me to help clear up any misunderstandings just let me know.”

“Haha, honestly, I didn’t expect things to get out of hand like that yesterday. If anyone needs to apologize it’s me. Luckily, after I explained everything to my husband, he calmed down. He even woke up early and made me breakfast this morning!”

She clearly found the whole thing funny in hindsight.

Zhou Can had even warned her not to close the office door to avoid any awkward misunderstandings. But fate had other plans—she got caught up with work and forgot her wedding anniversary. Her husband showed up at the hospital with gifts, only to find her and Zhou Can shut inside the office for ages.

“Glad that’s all sorted. Did the child get those tests?”

Hearing everything was fine, Zhou Can finally relaxed a little.

“Most of the departments had already clocked out yesterday, so it couldn’t get scheduled. But I spoke with the family and they agreed to the tests. They should be finished by this morning.”

By the time Zhou Can left her office, it was nearly eight in the evening.

Most of the lab staff had gone home. Unless it’s a special case, the capsule endoscopy department always needs appointments scheduled in advance.

“Dr. Zhou, Dr. Zhou! There’s an emergency case over there—his face is turning purple!”

A nurse was looking around for a more senior doctor to lead the rescue. Problem was, handover hadn’t started yet and the highest rank on duty was an attending physician.

She spotted Zhou Can making a call by the window at the end of the hall and quickly ran over for help.

“Alright, I’m coming right now!”

Zhou Can ended the call and gave Dr. Tang Fei an update: “Dr. Tang, I have to go—emergency rescue.”

“Take care!”

And with that, their call ended.

Yesterday’s misunderstanding hadn’t made waves in her marriage. Zhou Can could finally set his mind at ease.

He sped after the nurse towards the emergency hall. Lying on a portable stretcher was an elderly patient, two anxious family members by his side. Dr. Xie was on night shift today and still on duty.

He was standing watch at the triage station.

The patient had already lost consciousness. Dr. Xie was doing everything he could, performing CPR.

But the patient’s face had a dusky blue-gray tinge—a sign oxygen wasn’t making it through, and his life was close to ending.

Dr. Xie’s technique was solid: perfect chest compressions, thirty in a row before each artificial breath.

For rescue breathing Dr. Xie chose mouth-to-nose instead of mouth-to-mouth.

That usually means it’s tough to open the patient’s mouth, or there’s severe trauma, or maybe the doctor’s mouth is smaller than the patient’s.

Movies and TV always show the male lead giving mouth-to-mouth to a drowning heroine—that’s just for drama, it’s not actually proper practice.

The right rescue technique is mouth-to-nose.

Also, when female doctors or nurses have to do CPR for a sudden collapse, they often have smaller mouths than male patients. If she’s strong-willed, she might also pick the mouth-to-nose method.

Because when a female doctor or nurse tries artificial respiration but her mouth is too small to fully seal the patient’s, the air will leak out and won’t reach the lungs.

That makes for an ineffective rescue.

Ordinary people sometimes try to breathe into a patient’s mouth without pinching the nostrils—that’s a pretty basic mistake.

“Looks like there’s some airway problem.”

With plenty of rescue experience Zhou Can saw right away: during rescue breathing, the patient’s chest was rising and falling.

That meant air was actually reaching his lungs.

He was helping the patient’s lungs expand.

We all know our lungs breathe by expanding and contracting. Or, to put it simply—imagine both lungs as balloons. When they’re puffed up, you’re inhaling; when they shrink, you’re exhaling.

This is easy to see during mouse dissections—the lung changes are obvious.

As for human anatomy cadavers, well, don’t even think about that.

Cadavers for medical study are always people who have already passed away. Doing research on live humans—that kind of cruelty is unheard of here.

Zhou Can stepped forward and tilted the patient’s head back further, propping up his chin with one hand.

It’s the classic head-tilt chin-lift maneuver.

The patient’s jaws were clenched tight—no way to open his mouth easily.

Using a bit of force, Zhou Can pried the patient’s mouth open a narrow two- to three-centimeter gap, then checked inside.

“So it’s the base of his tongue blocking the airway!”

At first he’d suspected choking on food.

But sometimes, when a person loses consciousness, their throat muscles relax, the base of the tongue slips backward, and it plugs the airway.

Since the tongue and epiglottis are all connected to the jaw, just like Zhou Can did—tilt the jaw up and it forces the tongue and epiglottis away from the back wall of the throat. That clears the airway right up.

With Zhou Can’s help, the obstruction cleared and color returned to the patient’s face bit by bit.

“How did he pass out?”

The patient was now completely unconscious.

Which is exactly why his tongue had dropped and blocked his airway.

“My dad’s had high blood pressure for years, and he really loves to drink. The doctors said he should stop, so we watch him closely. But this morning he went out early, bought a bottle of liquor, drank some, and pretty soon he started slurring his words and couldn’t keep his balance. We rushed him here. He was still awake and talking on the way, but then he just lost consciousness.”

The family were a middle-aged couple, probably in their forties.

The son was the one answering.

His wife didn’t say anything—just kept looking anxiously at the patient.

“Nurse Lu, did you take his blood pressure?”

Hypertensive patients really need to avoid alcohol—no one can predict what even one drink might do.

It’s particularly dangerous for elderly people.

“Systolic 180, diastolic 120.”

Nurse Lu was a veteran in the emergency department. She could always tell which cases needed a senior doctor’s help.

She had a knack for knowing exactly when to call for backup.

“Do a thorough workup on his heart and brain vessels! His condition looks serious.”

Based on the symptoms Zhou Can figured it was likely a brain hemorrhage.

People with high blood pressure have to keep it under control. If a bleed happens in the brain, the risk of a stroke shoots way up. The outcomes are often rough—hemiplegia is actually one of the better results.

……

Zhou Can headed into surgery and left the rest to the team outside.

By lunchtime, when he left to grab a bite, he heard that the patient did have a ruptured blood vessel in the brain—intracranial bleeding. He’d been moved to Neurosurgery for treatment.

At Tuyu Hospital, Neurosurgery actually covers brain surgery as well.

Some hospitals separate out brain surgery as its own department.

A lot of regular patients think ‘neurosurgery’ only means brain surgery, but that’s actually backward. Neurosurgery covers much more than just the brain.

Nerves extend all over the human body.

Neurosurgeons mainly study the nerves of the head and spine.

The head is like the control center; the spinal cord is the main highway to the rest of the body.

If a child gets injured practicing dance or from a fall, the spinal cord can take damage. Sometimes it leads to paralysis below the injury—often the legs.

That’s because the nerves inside the spinal cord got compressed or damaged.

When kids are stretching or backbending for dance, their limits are real. If they say it hurts, don’t force it. Go slow and increase the difficulty over time.

Some dance instructors assume they know it all—after all, none of their other students got hurt—so they treat every child the same way.

They believe in the ‘strict teachers make great students’ concept.

But really, if they ever get a child who’s a bit frail or push a move too hard, it can easily end in serious injury.

Sometimes the kid seems fine at first, just complaining of pain.

The teacher thinks she’s being dramatic.

But after anywhere from half a day to a couple of days, the child suddenly can’t move.

By then, there’s nothing you can say to fix it.

So, please, don’t make the mistake of thinking Neurosurgery and Brain Surgery are the same.

The brain is the nerve center, but Brain Surgery isn’t just about nerves—it handles blood vessels, brain herniation, and other issues, too.

As Zhou Can ate lunch, he checked his phone messages.

He really was just too busy.

If he wanted to reply to Su Qianqian or check his other messages, it could only be done during meals or after work.

“Dr. Zhou, the child’s test results are back. I’m sending them to you now.”

If Dr. Tang Fei was affected, she didn’t show it. She sent Zhou Can the results like nothing happened.

Director Xueyan hadn’t been in contact for the past few days, and Zhou Can was getting a little worried.

Zhou Can looked over the results—anti-gliadin IgG and IgA antibodies were both positive. So his diagnosis was right; the child definitely had celiac disease.

The anti-endomysial IgA antibodies were weakly positive.

That lined up with the patient’s symptoms.

The child’s celiac disease wasn’t typical.

Capsule endoscopy showed swelling in the second, third, and fourth sections of the small intestine. The lining was swollen and had a brain-like pattern, with spotty patches of erosion.

With that, there was no room for doubt—diagnosis confirmed.

No wonder the child’s stool tests kept coming back intermittently positive for blood.

The small intestine is one of the body’s three main nutrition-absorbing organs and, in fact, the most important one, with advantages no other organ can match.

Not only is it the longest organ, but inside are countless folds, and the walls are covered with millions of villi and tiny microvilli.

This gives it a total absorption area of over 200 square meters—a staggering number.

Just think about that a moment.

Most of us live in homes just over a hundred square meters—the intestine’s area is roughly the size of two small three-bedroom apartments!

Reading on, the results showed swelling in the fifth and sixth segments of the small intestine, with surface bleeding spots.

And the sixth segment even had an ulcer.

It was small, only about 2.5 by 2.5 millimeters. A white film covered it, and the surrounding tissue was clearly inflamed.

At this point, there was really no need to test further—celiac disease was the clear answer.

“It’s good to have a confirmed diagnosis. We can treat for celiac disease now. Hope the kid gets better soon.”

After reading the results, Zhou Can finally let out a huge sigh of relief.

Every time he figured out what was wrong with a patient—or watched one recover and go home—he couldn’t help but feel proud and genuinely happy.

The whole reason he became a doctor was to help people out of pain.

Take this child, for example: he’d already been seen by countless experts, treated over and over, but the illness kept coming back. By the time his family brought him to Tuyu Hospital, their hopes must have been close to gone.

That’s the reality for many patients and families.

When a disease doesn’t clear up after a couple of hospitals, people usually lose faith and assume it’s some rare, impossible-to-cure problem.

No sooner had Zhou Can finished replying than Dr. Tang Fei called him outright.

He took the call.

“Dr. Zhou, done with surgery yet?”

“Yep, just finished. Grabbing lunch in the cafeteria.”

“Any suggestions for the child’s treatment?”

When it comes to celiac disease, the pediatrics department is fully capable.

The real challenge is diagnosis. Especially with atypical cases like this—it’s easy to mistake it for a duodenal ulcer or enteritis.

And sure enough, capsule endoscopy found an ulcer in the sixth segment.

But treating it like a regular ulcer would be useless.

Dr. Tang Fei was asking for Zhou Can’s advice not out of obligation, but real respect.

“Nothing special—just a gluten-free diet. Since there isn’t much diarrhea, no need for steroids. Most important is giving the family a heads-up about long-term follow-up and regular treatment.”

Zhou Can really didn’t have any other outstanding suggestions.

He owed a lot of his celiac disease know-how to the chief physicians in Gastroenterology—they’d helped him tons during his time training there, and they never held anything back.

Dr. Tang Fei took all of Zhou Can’s advice on board.

No sooner had he finished talking with her than Director Le from Cardiothoracic Surgery messaged next.

After checking a recent patient who’d had a cardia cancer total gastrectomy, the results were in. Zhou Can’s hunch was right—it turned out the pain came from refluxed bile and pancreatic juice attacking the esophageal lining.

So at least the cause was clear, but since the surgery was already done, fixing things would be tough.

“To really help her, we’d probably need a second surgery—though even then, it could only relieve symptoms, not cure the problem entirely.”

That was the message Zhou Can sent back to Director Le.

This was all because Director Le’s original surgery plan hadn’t taken everything into account. If they’d foreseen the risk of bile and pancreatic juice reflux post-gastrectomy, they might have tried a more difficult surgical route in the first place.