Chapter 591: Unraveling a Medical Mystery

Zhou Can had seen all sorts of strange cases in his career.

Over in obstetrics, there was even a baby born with its heart outside the chest. Surgeons managed to place it back inside, and against all odds, that tenacious child is now five years old.

But this patient’s internal hemorrhage was bizarre. Blood pooled in the abdominal cavity, yet the patient vomited a massive amount of blood from the mouth.

From a medical perspective, this just didn’t add up.

“Do we really need an autopsy to determine the exact cause of death?”

Hospital Assistant Qin might not be a clinician, but his background is in medicine.

He knew full well that the cause of this patient’s death was shrouded in mystery.

“Let’s start by reviewing the CT and ultrasound images. Maybe we’ll spot a clue that breaks this case wide open.”

That’s how Zhou Can responded.

Two things were clear now. First, the patient definitely didn’t die from a ruptured bladder with urine leaking into the abdomen. In fact, the patient likely had no urine output at all before passing. There are many causes for this, most commonly severe organ failure in intensive care, especially kidney failure.

In this case, it’s likely that the patient lost so much blood it caused the kidneys to shut down.

But for now, that’s still just a hypothesis.

Second, it was looking more and more like the patient died from a ruptured aorta and massive bleeding. Many of the final symptoms lined up perfectly.

The patient’s scans from earlier were quickly pulled up.

Ultrasound images are usually done in real time, so the doctor has to perform, interpret, and report them all at once. Only a few key images are saved with the report.

Fortunately, the CT department saved six images. Some didn’t make it into the final report, but they were archived anyway.

Zhou Can reviewed each image closely.

“I’ve found something!”

He couldn’t help but get excited, pointing to a spot on one scan.

“Look here—there’s clearly an aneurysm.”

Everyone stared at the image, and sure enough, spotted an aneurysm.

“It looks like it’s in the liver area—a hepatic artery aneurysm, maybe?”

“Not just looks like, that’s exactly what it is—a hepatic artery aneurysm.”

Director Shi and Director Shang both chimed in after taking a look.

Still frowning, Zhou Can studied the scan a little longer and added, “This aneurysm’s location is strange—down in the lower right liver lobe. That’s right next to the duodenum and colon.”

He stopped there, choosing not to say more.

In medicine, you can’t just make wild guesses—rigor is essential.

Whatever the diagnosis, it needs to be backed with medical data.

Ideally, every conclusion rests on clear test results—labs, imaging, or even other specialized assessments.

With the current set of records, Zhou Can’s bold guess couldn’t be fully confirmed.

“Dr. Zhou, what are you thinking? Go ahead and say it—everyone here works at this hospital.”

Deputy Chief Xiong, evidently a friend of Director Shang, was quick to support the Gastroenterology Department.

“I suspect this hepatic artery aneurysm invaded the duodenum. In other words, the artery grew into the duodenum, so their walls became fused.”

It’s kind of like two houses built right against each other, sharing a wall to save on costs and space.

“If that’s really the case, then it’s almost unbelievable!”

For once, Director Shi didn’t argue, but instead marveled at the weirdness inside this patient’s body.

“A huge artery aneurysm stuck to the duodenum… If it ruptured, blood would pour into the digestive tract. Some would spill into the abdominal cavity along both intestines; the rest would rush into the stomach. That explains all the vomiting of blood before death. Yeah, that makes total sense.”

Director Shang’s eyes sparkled. He looked genuinely pleased to have found the real cause.

“It sounds unbelievable, but the facts speak for themselves. In the liver area, there aren’t many pain nerves, so even a rupturing aneurysm might not cause severe discomfort. I support Dr. Zhou Can’s theory.”

Within the first team of Quality Control, Director Shi’s opinion held a lot of weight.

Especially during cause-of-death investigations, his word carried authority.

Now that he’d endorsed Zhou Can’s conclusion, it was as close to official as it could get.

While the hospital takes death reviews seriously, they also move quickly to keep things simple.

They’d never allow grieving relatives to stage a scene with wreaths and paper money at the hospital.

That sort of event would look terrible for everyone involved.

“Good work, everyone! The cause of death is settled—now the Medical Department can handle the next steps. Make sure to comfort the family, explain what happened, and offer as much practical help as possible. The hospital should show real compassion here.”

Hospital Assistant Qin wrapped things up.

Most of his instructions were directed at the Medical Department.

“Zhou Can, well done! Both vice directors were right to recommend you for Quality Control. Work hard—the hospital needs capable, brave, and careful people like you.”

With that praise, Assistant Qin stood up.

“We’re done here!”

This was Zhou Can’s first mission with Quality Control, and his performance left Hospital Assistant Qin very impressed.

The other two team members also looked at Zhou Can with newfound respect.

“Let’s go.”

Director Ju called over to Zhou Can.

“Coming!”

Zhou Can nodded.

He still wasn’t sure exactly what Director Ju Shiman’s position was, but given her role in the Nursing Department, it was probably an important one.

That she was now going out of her way to be friendly counted as a sign of acceptance.

“Quick thinking, solid skills—not bad at all!”

Director Shi smiled and praised Zhou Can.

“You flatter me! I’ve still got a lot to learn from you veterans.”

Zhou Can was careful not to get cocky.

Director Shi carried serious influence today—it was clear his standing in Infection Control was substantial.

Most members of Quality Control worked there part-time, but Infection Control was different—their team focused on it full-time.

Just like Zhou Can’s main job remained in the Emergency Department.

“Thank you, Zhou! Really—thank you so much!”

Director Shang gripped Zhou Can’s hand tightly.

If Zhou Can hadn’t cleared the air about the patient’s death, the Gastroenterology Department might have faced some trouble.

The young nurse, too, watched Zhou Can leave with eyes full of gratitude and admiration.

Maybe because of her junior status, she didn’t dare step forward to speak.

She just stood back, watching from a distance as he left.

……

Time flew by—in the blink of an eye, more than eight months had passed.

Zhou Can’s position at Tuyu Hospital grew more and more solid, rising step by step. He’d gone from a behind-the-scenes, somewhat well-known doctor to a bona fide department-level figure.

Now he’d made a mark in both clinical medicine and hospital management.

Clinically, he now saw patients in the Emergency Department for half a day each week, and in Pediatrics for another half day. Even just as a resident, his appointment slots were harder to get than some specialists.

Pediatrics Director Tang and Emergency Director Lou had both talked to him. They offered to upgrade his outpatient slot to a special appointment, with the consultation fee bumped up to 32 yuan.

That put him on par with associate chief physicians.

It meant a significant boost to his income. While the whole fee wasn’t his, a good chunk would come back to him.

Even just his half-day in Pediatrics, he’d easily see fifty patients.

People were always begging him to squeeze in extra appointments.

He usually caved and gave them one. Once, during flu season, the Pediatrics Department was flooded with sick kids.

Kids have weak immunity, so it’s easy for them to catch all sorts of viruses.

But their bodies bounce back fast—as long as they’re treated promptly, they recover quickly.

That time, he took on thirty-one extra cases.

He didn’t finish until well past nine that night.

Laboratory, ultrasound, and CT all kept working late alongside him.

Director Tang personally coordinated those departments to cover the overtime.

Otherwise, once they clocked out, there’d be no way to get the tests ordered by Zhou Can.

That marathon left a mark on everyone in Pediatrics.

Even Dr. Zhuang and other big-name pediatricians hadn’t gotten that sort of backup.

That very night, Zhou Can ended up saving two young lives. One child had a persistent high fever—treated everywhere from the local People’s Hospital, to the Traditional Chinese Medicine Hospital, to the Maternity and Child Hospital.

The family was picky and highly suspicious.

When two days of treatment at the People’s Hospital didn’t break the fever, they rushed to the Maternity and Child Hospital. Someone told them it specialized in women and children—supposedly more professional.

They spent nearly half a day in line, finally got some medication.

But after another sleepless night, nothing improved. The family listened to another ‘friend,’ and switched to the TCM hospital instead—supposedly no side effects there.

A whole day went by with no change.

All the shuffling around actually made things worse. Now the kid was gasping for breath, his lips turning blue—frightening to see.

The family was terrified, and so were the doctors and nurses at the TCM hospital.

What if the kid died right there in their care?

The family’s paranoia and the staff’s fear finally led them to recommend transferring the kid to a top-tier hospital. In their panic, the family posted a plea for help on social media.

Someone replied: Zhou Can in Tuyu Hospital is famous for handling critical emergencies.

The family jumped at the news and drove straight to the provincial capital.

By the time they arrived at Tuyu Hospital, office hours were long over.

But a nurse mentioned Dr. Zhou Can was still seeing patients, just with a full schedule—and that he only did Pediatrics a half-day each week.

The family felt both hopeful and desperate.

They barged straight into Zhou Can’s clinic room, the mother dropping to her knees as soon as she walked in.

Or maybe she collapsed from exhaustion—either way, she was at her limit.

The child was in grave danger.

“Dr. Zhou, please—I’m begging you, save my son…”

Zhou Can had seen plenty of family members throw themselves at his feet, desperate for help.

Truth be told, he didn’t have much patience for those types.

He’d helped patients out of kindness, only to be slapped with complaints later. In his experience, families who kneeled like that tended to be demanding, prone to extremes.

They never tried to see things from the doctor’s perspective.

Whatever they thought was right—was right, no matter what.

That day, Zhou Can worked overtime until after eight, running on empty.

There were still seven or eight extra patients to see.

He just gritted his teeth and kept going.

When he saw the mother kneeling with her child, he was about to ask the triage nurse to send her out—but then he noticed the kid’s face was literally turning purple. The situation was dire.

He quickly apologized to the waiting patients and prioritized the emergency.

Thankfully, after a round of urgent treatment, the child stabilized.

Zhou Can breathed a long sigh of relief.

Only after asking some questions did he realize why the situation had spiraled.

The kid probably just had a bad cold and persistent fever—a tough case, but easily handled by any county-level hospital. The real problem was the mother’s paranoia, her endless second-guessing of the doctors, and Googling everything.

How can any doctor treat a patient properly when they’re constantly being questioned?

In fact, on the second day at the People’s Hospital, things were already improving—but the family, lacking medical knowledge, let their suspicions run wild and dragged the kid everywhere.

All that chaos had made things worse.

Once he finished up with the last patients, Zhou Can was ready to head home. But then, the five-year-old daughter of the Health Bureau’s top boss—sick and already hospitalized at the Provincial Children’s Hospital for four days with no improvement—started vomiting blood.

That night she vomited blood.

The experts at the Children’s Hospital panicked—a high-profile patient dying on their watch would haunt them forever.

But they were all stumped.

Eventually, the Health Bureau boss figured Tuyu Hospital might just stand a better chance.

In desperation, he called Director Zhu for help.

Director Zhu hadn’t practiced clinical medicine in a long time. All he could do was point the boss to Pediatrics Director Tang Fei.

Director Zhu was savvy—he knew this hot potato could easily land him in trouble.

His real aim was to avoid getting involved wherever possible.

After all, the child was already being treated in the top hospital—nothing wrong with their expertise.

If that many pediatric experts couldn’t help, what chance did anyone else have?

No glory in success, only blame if things went wrong.

But Director Tang Fei just couldn’t say no to the Health Bureau’s top boss and agreed to take the case.

Maybe it was because Pediatrics, over the past couple of years, had solved a string of tricky cases thanks to Zhou Can’s help. Especially in just the last year, Zhou Can had gotten even better—there were almost no conditions he couldn’t handle.

The only exceptions were genuine medical dead ends or terminal late-stage patients—those were beyond anyone.

But as long as there was hope, Zhou Can and the pediatric experts would fight for a cure together.