Chapter 476: Troubled Recovery: The Patient No One Wants

The Third Hospital was the first to set its sights on Tuyu Hospital—kind of like a foolish rabbit feasting on the grass right outside its own burrow.

Zhou Can started to take a close look at this problem patient.

After being diagnosed with a sternal tumor, the patient had undergone extensive sternum resection and chest wall reconstruction.

Now, the patient was dealing with a post-surgical wound infection and sternal osteomyelitis, keeping the wound from healing.

The Third Hospital had tried all sorts of treatments, but nothing seemed to work. The family, afraid their loved one might die there, took the initiative to request a transfer.

According to the family, the doctors and nurses at the Third Hospital—and even other patients’ families in the same ward—all claimed Tuyu Hospital’s skills were top notch.

Two days before the transfer, a nurse was administering an IV when the patient’s arm swelled badly due to long-term use at the same site.

When she switched to the other hand, she missed the vein three times before finally getting it right.

The original attending was on leave for personal reasons, replaced by a new, careless doctor who was borderline negligent. Any complaints from the patient or family were brushed off.

Right at that time, another patient’s family in the same ward quietly tipped them off: word was, Tuyu Hospital’s Cardiothoracic Surgery Department had solved several tough cases lately.

That was all the family needed to hear.

They pressed hard for a transfer.

Zhou Can couldn’t help but smile—these antics from Xinxiang Hospital were practically designed to encourage patients to leave. The family might not understand the trick, but he saw right through it.

There was something else interesting at play—Xinxiang Hospital sang the praises of Tuyu Hospital. Was that genuine admiration, or were they just returning a favor from Tuyu?

Hard to say, really.

If it’s about repaying kindness, that might be stretching it.

Back then, Xinxiang Hospital had joined the Provincial People’s Hospital and the Third Hospital in ganging up on Tuyu’s Cardiothoracic Surgery Department, trying to snatch away its patients.

Still, maybe Tuyu’s earlier decision to send a team of experts to Xinxiang Hospital left a lasting impression.

Tuyu’s strength had clearly left its mark on the staff at Xinxiang.

Add to that, Tuyu’s Cardiothoracic Surgery had been rather high-profile recently, frequently publicizing their successful cases. It all built up an image of solid capability.

This patient’s issue was clear-cut: a post-surgical infection with sternal osteomyelitis.

The real challenge was in treating it.

After the infection set in, Xinxiang Hospital tried all sorts of antibiotics, but nothing worked.

Sometimes, antibiotics just aren’t a cure-all.

Especially with serious infections—simply relying on antibiotics just isn’t enough.

Take something as basic as an abscess. If there’s an infection, and you try treating it by injecting antibiotics, as long as the pus remains, you’ll never fully cure it. At best, you suppress it.

The right thing to do is drain the pus, clean out the abscess, make sure no source of infection remains, then follow up with antibiotics.

Only then do you have a chance at a real cure.

And remember, any use of antibiotics comes at the cost of weakening the immune system.

Experienced doctors never take this lightly when prescribing antibiotics.

Some patients love running to little clinics for an IV whenever they get a headache or fever. Sure, it works fast, but the next time they catch a cold, it’s even worse.

[A novel app that’s been stable for years, as good as the classic Reader’s Genie—the veteran readers all use the Huanyuan app to switch sources.]

That’s because repeated antibiotics weaken the immune system.

In recent years, many pediatricians in the country have pointed out that most nursing infants with colds or fevers can self-heal thanks to antibodies in breast milk. Each recovery gives their immune system a little boost.

It’s like the baby gets a natural workout for its immune system every time it falls ill in this new world.

If the family is overprotective and always rushes the baby to the hospital for shots and meds, the child misses out on developing real immune strength.

Once these kids are weaned, their resistance is often much weaker.

That’s why breastfeeding has become so strongly advocated in recent years.

It’s not just about avoiding contaminated milk powder. Breast milk’s natural antibodies really do enhance a baby’s immunity.

With this patient, Xinxiang Hospital’s aftercare boiled down to antibiotics.

It was just like that abscess—they tried to fight an infection without removing the source.

You have to find the source and eliminate it before antibiotics can finish the job.

Viewed this way, Xinxiang Hospital’s foundation was lacking.

They could handle sternum removal and chest wall reconstruction, but their post-op management fell short—treating the infection simply stumped them.

Zhou Can started to review every step of the operation and all the patient’s follow-up exams.

The surgery itself wasn’t complex: general anesthesia, intubation, locate the tumor, choose an incision.

After making an incision through the skin and underlying tissues to expose the sternum, they severed the muscles attached to it.

Then, they cut out the tumor along with some surrounding healthy tissue.

When dealing with malignant tumors, seasoned surgeons never hesitate—they always remove extra, just in case.

The tissue next to the tumor may look healthy, but cancer cells could have already spread.

An incomplete operation can be disastrous.

The cancer would just come roaring back.

Most malignancies only grow faster when provoked.

The classic case of the higher the wall, the higher the demon climbs.

The tumor removal had followed all protocols—no problems there.

Zhou Can focused on the later chest wall reconstruction procedure.

Since there’d been no infection before surgery, they chose artificial material for the chest wall rebuild.

Specifically, they picked a plexiglass plate.

After the chest wall was rebuilt, Xinxiang Hospital placed a drainage tube in line with standard operating procedure before suturing the wound.

For cases with large chest wall defects, a drainage tube is a must.

Only with a minor defect can you close up directly, skipping the drainage.

“Is the real problem with the artificial material?”

Zhou Can had seen plenty of cases thanks to his own experience—and everything Dr. Hu Kan had passed down.

After going through the case and considering the symptoms, he quickly locked in on the most likely cause of infection.

He’d seen first-hand how lax Xinxiang’s staff could be. It was entirely possible that sloppy post-op care played a role.

He decided to visit the ward and assess the patient himself.

Once there, he saw the patient—a man in his 40s.

The medical chart said he was 48.

Fifty is the age of fate.

At 48, he wasn’t young or old, but his body wasn’t bouncing back like it used to.

You could clearly see signs of infection around the scar on his chest.

Thanks to ongoing antibiotics, the area was red and swollen, but not showing obvious pus.

It could be worse.

Most likely, Cardiothoracic Surgery had already screened the case. Patients with fatal complications almost never actually get admitted.

“How are you feeling now?”

After checking him over, Zhou Can asked.

Since ancient times, proper diagnosis has relied on observing, listening, questioning, and physical exam. Asking about the patient’s condition helps the doctor get a clearer sense of what’s going on.

Why are pediatric cases so tough?

Because most kids under three can’t tell you where it hurts or what feels wrong.

They just know they don’t feel well.

Treating these “silent” cases is exhausting for any doctor.

“It hurts… fever, can’t eat…”

The patient struggled to speak, his face twisted in pain.

Every word tugged at the wound on his chest, sending another wave of agony.

If the wound wasn’t infected and was healing up, he wouldn’t be suffering like this.

“Doctor, if you have questions, let’s talk in the office. My father’s in a lot of pain and we’ve explained everything to your attending doctor and Director Xue already. I hope you’ll understand and not keep repeating the same questions.”

His daughter was dressed in fur, high heels, and tight black leggings—even sitting in the ward, her brows were drawn and lips painted a bold red.

She was young, maybe twenty-four or twenty-five.

With delicate features, big eyes, and a sharp chin, she was strikingly pretty and lively.

But her words were blunt and forceful.

“Symptoms can change with the course of an illness. We ask daily not to repeat ourselves, but to stay on top of the patient’s condition. If anything new comes up, we can catch it right away.”

Zhou Can was long used to dealing with sharp-tongued families and stayed calm as ever.

“Yeah, yeah. I can’t out-talk you. If there’s anything new, I’ll speak to the attending or tell Director Xue during her rounds. Please don’t disturb my father if you can avoid it. You can always come to me with questions.”

She sounded tired of the whole exchange.

Clearly, she took Zhou Can for just another ordinary doctor, not knowing she was actually talking to someone outranking even Director Xue.

“Noted.”

Zhou Can nodded and left the ward.

Arguing with families was never worth it.

Some families thought they understood hospital hierarchy—they’d never dare offend a Chief Physician, and they’d butter up the attending as much as possible.

As for nurses and other doctors, they couldn’t care less.

After all, they didn’t affect the patient’s care.

Of course, running into these snobby relatives left nurses and doctors feeling helpless—but few would ever take it personally.

These days, it isn’t just the debtor who thinks he’s king—even in hospitals, the ones holding the complaint card act like they own the place.

Because in their mind, the customer is always right.

They’re paying for treatment, so they expect to be treated like royalty.

But really, healthcare is a resource, not a service industry. When it counts, it saves lives—something no restaurant service could ever provide.

If medical staff were expected to grovel and flatter patients and relatives, it would truly be a tragedy for all the sick.

In developed countries, there’s a new trend—private medical teams.

If you can pay, they deliver the absolute best care—completely professional, utterly attentive. The only problem? It’s expensive enough to bankrupt a middle-class family after one illness, even in the richest countries.

Many people would rather die at home than go bankrupt getting treated.

It’s just too costly, plain and simple.

Back in his office, Zhou Can continued puzzling out the underlying cause of this post-op infection.

“If I’m right, during chest wall reconstruction, artificial material without blood supply made healing nearly impossible. Add in poor care, and infection was almost guaranteed.”

[Pathology Diagnosis experience +1. Bonus: Pathology Diagnosis experience +100.]

He was right.

His eyes lit up with understanding.

At that moment, Director Xue finished her own surgery and came straight to the main office to see him.

“Zhou Can, I heard you just checked on the patient in Bed 73. That one was transferred from Xinxiang Hospital after post-op infection—they couldn’t handle the case. Got any leads?”

After her divorce, she’d poured herself into work, using the pressure to survive the hardest days.

Zhou Can and Director Le knew about her situation, so they tried to offer extra support.

Her ex-husband, by all accounts, was a real piece of work—fighting tooth and nail for the house, leaving Director Xueyan forced to rent after losing her only home.

A woman fighting a man in court is almost always at a disadvantage.

The guy hoarded the house, and her family had no men to help her out.

If she tried to take it by force, she’d probably get beaten.

Legal action was her only option, and that takes time.

Director Xueyan had confided in Zhou Can: she’d decided to give up the house if it meant a clean break, and would trade the property for custody of her kids.

It wasn’t his place to intervene—Zhou Can could only do what little he could to support her.

“I’ve made some progress. I think the infection is probably related to using artificial materials during reconstruction, making the wound harder to heal. Couple that with poor nursing, and infection was almost inevitable.”

Any wound that won’t heal quickly is bad news.

Even with careful management, the risk of infection increases many times over.

“I suspect the same thing. But if we remove the artificial material and just rebuild with soft tissue, his chest wall could end up unstable. Do you have a solution?”

Both she and Zhou Can were top students of Dr. Hu Kan and masters of cardiothoracic diagnostics.

“We do have an option. If we’re going to operate again anyway, let’s just go bigger and use the patient’s own bone—ribs make a great replacement.”

Zhou Can outlined the surgical plan.