Chapter 615: Unraveling the Child’s Mysterious Paralysis

The child on the bed has noticeable stiffness on the right side of his neck, and his right knee’s reflex is weak. Both symptoms point to a problem with his nerve pathways. It’s important to remember that just because the lower nerve centers are clear doesn’t mean all his nerves are working normally. Given his fall from a great height and the obvious hematoma on his neck, there’s clear evidence of cervical spine injury, very likely with spinal cord involvement.

Director Yin saw his agreement and started a serious discussion about the child’s condition.

Every time the cause of an illness comes up, he can’t help but wear a focused expression, meticulous to the core.

Becoming a top neurologist in the department doesn’t happen by chance.

His rigorous attitude toward medicine is worth learning from.

“Besides possible spinal cord damage in the neck, I suspect the child’s brain could also be injured,” he continued.

Director Yin kept going with his analysis.

When both the brain and cervical spinal cord are injured, that’s what Director Yin calls a complex neurological disorder.

“But the child’s head CT scan and ultrasound showed nothing abnormal!”

CT scans are really effective for spotting tissue changes, tumors or vascular problems. When it comes to head ultrasounds, they’re mainly used to check blood flow.

They can detect things like compressed or ruptured blood vessels very effectively.

After carefully reviewing the child’s test results, I couldn’t find any abnormalities.

I’ve honed my diagnostic skills through years of practice. Now that I’m at the chief surgeon level and have mastered skills across multiple departments, my ability to read scans is even stronger than most chief physicians or med techs.

I can pick up on details others might miss.

“Sometimes, brain injuries simply can’t be detected by ultrasound, CT scan, or X-rays. Even top-level MRIs might not catch them. Brain tissue is as delicate as soft tofu. When a child takes a hard hit to the head, issues can arise. Especially in kids whose skulls have only just fused and whose organs are still developing—it’s far easier for damage to occur.”

“The most common result? Concussion,” he added.

Director Yin shared his diagnostic insight.

Those words sparked new ideas for Zhou Can’s own diagnosis.

“So you mean I should evaluate both his brain and cervical spinal cord at the same time?”

“Exactly!”

Director Yin’s pleased smile showed he saw real promise.

“I’ll give you one more diagnostic angle. Sometimes, a patient already has a dormant disease with little or no symptoms. Often those pre-disease periods are subtle. For example, maybe the child already had a nerve or spinal problem, and this fall just triggered it—causing the sudden paralysis?”

That’s another deeply experienced line of reasoning.

Younger doctors rarely think along those lines.

Coming to see Director Yin turned out to be a great learning experience for Zhou Can. He stood up, ready to leave.

“Not so fast, I’m nowhere near done!” Director Yin shot him an annoyed look.

Zhou Can had no choice but to sit back down.

“There are two swellings in the spinal cord. The upper one is called the cervical enlargement, spanning the third cervical segment to the second thoracic segment. The lower one is the lumbar enlargement. When someone presents with spinal paralysis, you focus on these two spots. For a child like this with high-level paralysis, I suggest you concentrate on the cervical enlargement. If needed, consider a puncture or minimally invasive exploration. If you’re unsure about invasive testing, talk to Director Wu from Neurosurgery—he’s the expert.”

Director Yin offered yet another valuable suggestion.

Years of hands-on experience went into these insights. Sharing them freely, he left Zhou Can feeling grateful.

When Director Yin finished, Zhou Can stayed seated, quietly watching him.

“I’m done. That’s all the advice I have. Unless you want me to share a few classic, really tough neurology cases?” Director Yin teased with a mischievous grin.

“Uh… Next time, next time! I’ve learned a lot from you today, so I should hurry back and put it to use. The paralyzed kid is still waiting! Thanks again for your guidance. I’ll get going!”

Zhou Can stood up and waved.

“The tea here is fantastic. Actually, our Emergency Department has some good tea too. If you come over, I guarantee I’ll steal Director Lou’s finest stash just to brew a pot for you.”

He was only half-joking.

Now that Zhou Can was the department’s deputy director, they’d even given him his own office to win him over.

Even Deputy Director Han Changqing, who had been there much longer, didn’t get that privilege.

But Director Han was about to retire anyway.

He didn’t care much about appearances—what mattered most was post-retirement benefits.

Doctors with official status can usually expect their retirement salary to be at least 80% of what they made before. That’s why, right before retiring, most try to get promoted as high as possible.

A higher rank means a better pension down the line.

As for tea, Zhou Can had a collection of his own—better than anything in Director Lou’s reserve.

He also had an impressive variety of tea to choose from.

Being a low-key co-owner of Jin Yu Interactive, he was used to people currying favor. Anyone trying to get ahead would slip him a gift whenever they sent something to Mr. Li.

Even though Zhou Can always told Mr. Li not to take gifts for him, every time he visited the company someone would load his car trunk to the brim.

Back when he had no money, every box of tea or fine wine felt precious.

Now that he’d reached this level, those gifts didn’t mean much.

Rarity gives something its value.

“A man is noble when he wants nothing”—classic words that still ring true.

He received so many gifts that he didn’t even know who sent them. People weren’t expecting him to remember their names—just figured it was better to give than not.

If they didn’t, and Zhou Can objected to their promotion or a key position, just one complaint could ruin their chances.

Plenty of entertainers trying to climb the ladder wouldn’t just spend money on gifts—they’d get dressed up and happily stay up all night talking business with Zhou Can.

Even advertising partners and companies with ties to the entertainment world made a point of sending gifts to Jin Yu Interactive’s bosses every holiday.

When Zhou Can left Director Yin’s office, it was already 8:26 PM.

Time just flies.

He always felt like there was never enough.

There were always more patients to treat and more work to be done.

Returning to the Emergency Department, he decided to see if tonight he could finally crack the cause of the child’s illness.

As the department’s deputy director, he had plenty of authority now.

He could use medical resources directly without needing Director Lou or Dr. Xu’s sign-off.

Another advantage of Emergency compared to specialty departments—it never closes.

Other departments usually have staff clock out after hours, leaving only a few on duty for inpatients—which means nothing much can get done overnight.

But not the Emergency Department. It’s staffed 24/7.

Critical and urgent patients can arrive at any time and get immediate care. No waiting until the next day to start rescue efforts.

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All kinds of emergency tests are available around the clock.

Even surgery can start right away—even if it’s 3 AM—if a patient needs it.

He grabbed the child’s test reports and other materials for a closer look.

There are two main types of nerves: central and peripheral.

But in terms of connections, only two matter: those linked to the brain, and those linked to the spinal cord—the so-called spinal nerves.

Director Yin suggested the child might have issues with both cranial and spinal nerves.

That meant Zhou Can had to find a way to confirm each one.

Functionally, nerves split into two main types: sensory and motor.

Zhou Can decided to revisit the ward to test the child’s sensory nerves.

Sometimes, don’t be annoyed if a doctor seems thorough.

Ideally, a doctor would figure it all out in one go, but for tough neurological cases, you might get checked dozens—even a hundred—times. If your doctor is willing to spend all that valuable time, consider yourself lucky.

It means you’ve found a responsible doctor.

If patients or families don’t appreciate that and are rude or uncooperative—

Well, then the doctor might suggest a transfer or defensive treatments, and the patient will just have to accept the consequences.

A doctor could use that precious time helping more patients instead of spending it all on one.

Diagnosing tough cases is always more effort than reward.

Treating a standard patient might earn fifty yuan in performance bonuses, while a complicated case may pay three hundred—but the doctor still loses out.

And the more complex the illness, the bigger the risks for the doctor.

By the time he reached the ward, the child’s mother was watching over him.

The grandparents were temporarily staying at a hotel.

The owner of the inflatable castle and the young woman weren’t there either.

Honestly, the castle owner is only responsible for treatment costs. Given the distance, he doesn’t have to come in person.

But the child’s father isn’t an ordinary man. If the responsible party doesn’t show effort, a lawsuit could cost even more—being caught with problems could mean arrest.

No one wants to go to jail.

Showing goodwill is all about keeping the family satisfied and avoiding legal trouble.

The goal is to settle things privately.

“If people don’t report it, officials won’t investigate”—that’s true everywhere.

It’s always been true, all around the world.

Take restaurants, bakeries, cake shops—who welcomes an inspection? As soon as someone checks, they’re bound to find something wrong.

So long as customers don’t get sick and nobody files a report, the shop keeps its doors open.

“Dr. Zhou, you’re here!”

The little boy’s mother saw Zhou Can walk straight to the bedside and stood up to greet him.

She struck him as gentle, dignified, and kind.

“You’ve come all the way from the capital just for me. If I can’t figure out your child’s illness, I won’t sleep well. I’m going to test his sensory nerves below his neck. There are a few ways we do this—the gentlest is just touching the skin. If he feels nothing, then we use something sharp or a mild electric current. Is that all right with you?”

Truthfully, Zhou Can didn’t really want to test a child’s sensory nerves.

These days, parents treat their kids like the most precious things.

If they saw a doctor use electricity on their child’s body, they might fly off the handle.

In reality, the doctor means well—just trying to get to the bottom of things.

Medical disputes on this front happen often, especially in the resuscitation room.

When a patient’s heart stops or goes into fibrillation, electric shocks are needed for CPR—and the patient might scream.

Family members outside hear the cries and think the doctors are torturing their loved one. They bang on the doors, ready to burst in and attack.

“Will this hurt him?”

The mother’s voice was anxious.

“If his sensory nerves are working, he’ll feel a little pain. If they’re not, there’ll be no response. We do the test very carefully; it won’t cause any real harm.”

Zhou Can explained patiently.

“All right then. We’ve come this far, so we’ll put our trust in you.”

The mother agreed.

Zhou Can started the sensory test.

Above the neck, the child could sense touch. Below the neck, his sensory nerves were much weaker.

Normal touches didn’t register at all.

Only a cold object or something sharp on the skin got any kind of reaction.

As for hot objects—doctors rarely use that in tests.

Mostly because they’re afraid of getting hit by parents.

If things get out of hand and leave so much as a red mark, the family could raise a fuss.

There was another finding—the further down the body, the weaker the sensation.

The feet had the least feeling of all.

This time he made a major discovery. Director Yin had told him to focus on the cervical enlargement of the spinal cord. While checking the nerves, Zhou Can realized the function began to weaken at the medulla.

That meant the real issue was probably at or above the medulla.

Possibly even the pons.

Below the cervical enlargement, everything seemed normal.

The inner structure of the spinal cord is extremely sophisticated—anatomy here is a real challenge.

Any spinal surgery must be approached with caution.

You see big-hospital doctors boasting about doing countless spinal surgeries and disk operations, how great their success rates are—but plenty of patients just felt pain before surgery.

Afterwards, maybe the pain lessened, but some ended up in wheelchairs or completely paralyzed, unable to care for themselves in bed.

Those who can use a wheelchair are a bit better off, but for bedridden patients, life can be terrible.

No child is truly filial at the sickbed for long.

Anyone who spends half their life helpless in bed needs someone to handle their eating, drinking, bathing, muscle massages, limb stretches—and no matter how loving the family, that care can’t stay perfect forever.