Chapter 106 A Truly Difficult Case

A chance encounter in the inpatient wing leaves Professor He with still more questions about his former student.

“All right,” Professor He agreed. He issued the prescription without changing the doses or the combination of medicinals.

He told the boy to stay for a while after taking the medicine. He wanted to see how he responded.

The grandmother agreed.

Then the whole group headed for the inpatient wing.

When they arrived, a delighted voice called from nearby.

“Dr. Xu?”

It was the stubborn old man!

Evan paused. He could no longer remember who the man was.

“Hello, Dr. Xu.” The Abbess was there too.

Evan looked at her. He couldn't place her either.

Professor He looked at Evan as well.

“Dr. Xu, that prescription of yours was wonderful!” the old man said excitedly. “I took it and got better straightaway. I'm ready to go home, but they won't let me. They insist on keeping me another two days for observation.

“I can't stand staying here. A hospital isn't a fun place, is it? My appendicitis is better, and they still won't let me leave. It's ridiculous!”

At last Evan remembered. Treating that case of appendicitis had led to the article about him on a WeChat public account. That had given him enough publicity to return to the past and study under a mentor.^[1]

“Keeping you here for a few more days is the responsible thing to do,” the Abbess said coldly. “What have you got to complain about?”

“All right, all right. I'll stay another few days!”

The stubborn old man had finally met his match. He no longer dared argue with his daughter. Their relationship had only just begun to improve. If he argued away what little progress they'd made, that would be the end of it.

Turning to Evan, the Abbess gave a rare smile. “Dr. Xu, I still owe you my thanks. When are you free? I'd like to take you out for a meal.”

Evan shook his head. “I don't have time.”

Her expression stiffened slightly. “Then… could we add each other on WeChat?”

Evan was about to refuse.

“Since that article went up, a lot of readers have been messaging the account to ask where your clinic is,” she said. “Shouldn't we discuss how to promote it?”

“I'll have our boss contact you,” Evan replied. “I have a consultation to attend. Goodbye.”

With that, he walked away.

“Hey!”

The Abbess felt deflated. What was wrong with this man? Why was he always trying to get away? Was she that frightening?

She was beginning to doubt her own appeal. And to wonder about Evan…

The group continued upstairs.

“Was that someone you treated before?” Professor He asked.

“Yes.” Evan nodded.

“You can treat acute abdominal conditions too?” the professor asked, puzzled.

Evan smiled. “I know a little about everything.”

During his years in the system, Evan had spent decades moving between county towns and villages. One advantage of rural practice was that you couldn't choose your patients. Whatever illness they had, you had to treat it.

That was why Dr. Li, after decades in the countryside, could treat every kind of illness. Whatever illness his patients developed, he had to study it. He had no choice.

It was different in the city. Large hospitals had many departments, with doctors specializing in particular fields. Each had something they were good at.

Evan was being modest.

Professor He grew more doubtful.

Leo felt he ought to explain. “Professor He, that patient had appendicitis with an atypically located appendix. Instead of pain in the lower right abdomen, he had pain in the upper right. The ultrasound suggested acute cholecystitis too. Everyone misdiagnosed him. Dr. Xu was the only one who got it right.”

“What?” Now Professor He was truly surprised. “How is that possible? How did you do it?”

“Pulse examination!” Leo piled on the praise. “I've lived more than half my life, and that really opened my eyes! Dr. Xu felt his pulse and immediately said there were no signs of disease along its course through the Gallbladder, but there were heat signs throughout the Large Intestine. He identified it as an intestinal abscess straightaway. And he was right. I was convinced on the spot!”

Professor He looked at Evan quite differently now. “Gauging the pulse's course by the breath? That's a pulse method from the Nanjing. How do you know it?”^[2]

Evan gave a small smile. “I don't know much. Just a little.”

The Chinese medicine doctors following them could hardly stand it. Just a little? Not this again, damn it.

This chapter was lifted from the author's NovelPhoenix publication without permission; the original posting supports their work.

“You… what have you been doing these past six months?” Professor He asked in amazement.

For a moment, Evan didn't know what to say.

Leo continued his praise. “Professor He, Dr. Xu really is very good. There was a little child with severe adenovirus pneumonia. One dose, and all the symptoms subsided! The child was discharged not long afterward.

“Then there was the woman who couldn't pass urine or stool after giving birth. And that man with the persistent cough—he'd seen so many doctors, and none of them had cured him. And the patient this morning with the postoperative adhesive bowel obstruction. Dr. Xu wrote that prescription right in front of us.”

Professor He was so stunned he stopped walking. He turned to Evan. “Impossible! I know your level far too well. Even if a whole group of the country's finest physicians had been teaching you day and night for the past six months or more, you couldn't have improved this quickly!”

He was beginning to question everything he knew.

Evan forced himself to reply. “He's being too kind. I'm not that good. Come on, Professor. The patient's waiting.”

The professor resumed walking in bewilderment. He was beginning to wonder whether he'd misheard. Nobody knew Evan's abilities better than he did. The young man couldn't possibly have improved so fast!

They reached the ICU.

Dr. Qi and the others were waiting outside.

Dr. Qi hurried forward and offered his hand. “We have to trouble you again, Professor He.”

With a patient to see, the professor quickly put his questions aside. He nodded slightly. “No trouble. It's my duty.”

“Professor He, this is Dr. Patrick Shi, the head of the ICU,” Dr. Qi said.

Professor He extended his hand. “Hello, Dr. Shi.”

Dr. Shi was tall and powerfully built, with broad, thick hands and a deep, rough voice. “Hello, Professor He.”

Dr. Qi went on to introduce a middle-aged woman beside them. “And this is the patient's wife.”

Professor He looked at her. She leaned against the wall, haggard and silent.

“Marcus,” Leo called.

“Leo.”

The man standing beside the patient's wife resembled Leo, but was younger and taller. He stood very straight, his eyes bright and alert.

Everyone looked at Leo.

Leo chuckled. “This is my younger brother, Marcus Cao. He heads the criminal investigation brigade. They call him the Tiger of the Detective Squad. The patient is his mentor.”

Marcus came over and shook Professor He's hand as well.

“Tell me about the patient,” the professor said.

“His name is Gordon Gao. He's 55,” Dr. Qi began. “Thirty-five years ago, he suffered severe frostbite, which was treated successfully. Ten years ago, he suddenly developed coldness and pain in both legs. Repeated hospital treatment did nothing for him.

“Then his condition suddenly worsened around the Lunar New Year this year. He went straight to the provincial capital. He was admitted to the First Provincial Hospital, the Second Provincial Hospital, and the Provincial People's Hospital, spending seven months in hospital altogether.

“The diagnoses were hardening of the brain's arteries, an inferior-wall myocardial infarction—a heart attack affecting the heart's lower wall—and thromboangiitis obliterans in both legs.^[3]

“Amputation was recommended, but he refused, so he was discharged. On the day he returned to the county, he developed severe coldness and pain, along with tightness, a sense of pressure, and stabbing pain in his chest.

“A nitroglycerin tablet dissolved in his mouth gave him a little relief. At his family's suggestion, he came here for inpatient treatment. We admitted him directly to the ICU. His condition is very concerning, but he still refuses surgery. Here's his medical record.”

Dr. Qi handed it over.

Professor He took the record, frowning deeply. He hadn't expected such a difficult case.

Marcus Cao, the Tiger of the Detective Squad, addressed him solemnly. “Professor He, my mentor is a hero. He suffered that frostbite while he was serving on the frontier. There was a terrible snowstorm, and it triggered an avalanche.

“His whole company rushed in to save the people caught in it. Five soldiers died, and quite a few others suffered frostbite to their toes that left them permanently disabled.

“My mentor was lucky. He kept all his limbs, but there was lasting damage. After leaving the army, he was reassigned to civilian work here in the county. He's worked conscientiously at the local police station for so many years. With his abilities and everything he's done, he'd surely have risen beyond deputy station chief if it hadn't been for his health.^[4]

“So please, do everything you can. You have to save him. Please!”

Marcus finished with a salute to Professor He.

The professor's expression turned solemn.

But the patient's wife still leaned against the wall. She didn't look at him. Her head was bowed, her face full of quiet despair.

They'd already been to the provincial capital. They'd been to its best hospitals and received treatment from its best specialists.

They'd tried Chinese medicine too, with leading specialists from the province. And what had changed? Yes, Professor He was a provincial specialist. But so were all the others!

Reader Notes

Reader Notes

1. ↩︎ The public account and personal contacts. A WeChat public account publishes articles to readers; adding someone as a personal contact is a separate matter. The account's readers have asked where the clinic is, giving Ms. He a reason to discuss publicity. This recalls the earlier article; it does not mean Evan has accepted her contact request. Source: Tencent — Weixin Official Accounts.
2. ↩︎ The breath, the pulse's course, and “intestinal abscess.” The Nanjing, or Classic of Difficult Issues, describes the pulse's course in relation to inhalation and exhalation. This recalls Evan's earlier training in a traditional circulation model, rather than a measurement of modern blood-flow velocity. Gallbladder and Large Intestine here name traditional functional systems. Changyong, translated as “intestinal abscess,” is also a traditional disorder category; the term alone does not establish a modern abscess or appendicitis. Leo's account of Evan locating the problem through the pulse remains the novel's diagnostic claim. Sources: Nanjing Benyi — Difficulty One (in Chinese); WHO — Standard TCM terminologies, entry 1668.
3. ↩︎ Thromboangiitis obliterans. Also called Buerger's disease, this is an inflammatory disease of blood vessels, commonly in the arms and legs. Swelling and clot formation can restrict blood flow, causing pain and tissue damage; severe cases may involve loss of a limb. This explains the unfamiliar diagnosis in the report and why amputation enters the discussion. The account of Gao's old frostbite and subsequent illness is his history in the novel. The background definition does not establish a causal connection between the two. Source: CDC — Buerger's disease, overview.
4. ↩︎ From military service to civilian work. Zhuanye refers to a transition from military service into civilian employment. China's resettlement system has included organized job assignments, so leaving the army need not mean retiring from working life. This supplies the background to Gao's move into local police work. The passage gives neither his military rank nor the details of his placement. Marcus's “mentor” refers to his senior in police work, continuing the relationship described here. Source: Beijing Veterans Affairs Bureau — Interim measures for resettling military cadres, articles 2–4 (in Chinese).