Chapter 156: Sweeping Through the Wards

A request from the next bed gives Evan something to think about.

The patient in the next bed could no longer contain herself. “Doctor, could we have the Chinese medicine doctors treat us too?”

The young doctors paused. What was this about?

Evan was taken aback as well.

The woman in the next bed was middle-aged. She hurried to explain. “Your treatment works so well! I saw him when he first came in. All that blood he was vomiting—it was terrifying! Scared me half to death.

“They wanted him to have surgery, but he and his wife wouldn't agree. Who'd have thought Chinese medicine would work so well? One night, and the bleeding stopped. No more vomiting blood, and now he can even eat. He certainly won't need an operation now!

“And these doctors are so conscientious. They come several times a day, all lining up to take his pulse. I'd…well, I'd like that too.”

Evan was both amused and exasperated. So she wanted a whole queue of doctors waiting to take her pulse too.

This was the first seriously ill patient the Chinese medicine department had taken on since the academic center was established, and Evan was treating him alongside them. It was only natural for the young doctors to be excited.

The earlier patient—the woman who was a suspect—had been even more seriously ill. After Evan saved her, her care had also been handed over to the Chinese medicine department.

But her status meant these young doctors couldn't simply go in to see her, much less take turns examining her one by one.

In that sense, the man vomiting blood was their first seriously ill patient.

“You're not under our department's care at the moment,” Evan told the woman. “If you'd like a Chinese medicine consultation, you can ask the doctor in charge of your care.”

Then he led the others out.

Once outside, Evan thought for a moment. “There are so many patients in the inpatient wards. Most of them aren't under our department, but that doesn't stop you from going to see them.

“You can examine their pulses, look at their tongues, ask about their conditions, and make your assessments. You'll never become good at pulse examination just by memorizing books at home. You have to practice.

“You could spend some time examining these patients to improve your diagnostic skills. I don't think they'd object.”

The others' reactions varied.

“But would the other departments mind?” Alex asked cautiously.

Evan paused. That did seem to be a problem. But these young doctors had to develop their diagnostic skills somehow. Inpatients were different from outpatients. People coming for an outpatient visit had places to be. They didn't have time for all these youngsters to examine them one after another.

Inpatients were lying there anyway. Visit a few extra times, and they'd be happier, thinking how conscientious you were. Just look at the man vomiting blood: these youngsters lined up to examine him several times a day, and the woman beside him could hardly have been more envious!

It really was an excellent opportunity for the young doctors. Still, barging into another department to examine its patients wasn't quite appropriate.

Evan considered it, but couldn't think of a good solution.

The young doctors were troubled too.

“Ah!” Evan's eyes suddenly lit up.

Everyone looked at him.

“Here's what you do,” he told them. “Go through the inpatient wards, room by room, and examine every patient. Don't start by asking questions. Use the other examination methods first.

“Once you've reached your conclusions from those, ask about the symptoms and see whether they match your assessment. That's another way to develop your diagnostic skills.”^[1]

The others were taken aback.

“Dr. Xu,” Alex reminded him, “the problem isn't that we don't know how to practice. We're worried the other departments will object.”

“Hold on. I haven't finished. Go ahead and examine the patients. Write down your pattern assessments, but don't show them to the patients, and don't go prescribing medicine on your own.^[2]

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“If nobody notices, carry on. If someone catches you, tell them it's an assignment from Director Leo Cao and you have no choice. Tell them to take it up with him.”

“Huh?”

The young doctors were dumbfounded.

“We can do that?” They were stunned.

“Why not?” Evan said, as though it were perfectly reasonable. “Director Cao is one of the people in charge of our academic center. It's been running for several days, and I still didn't know what he was responsible for. Now we know.”

Alex gaped at him. “So his job is to take the blame for us?”

“What a way to put it! He's one of the teachers leading your group. His job is to help you learn from your clinical mentors. This is one way of doing it.^[3]

“Besides, Director Cao knows everyone and gets along with them. Who better to back you up? Don't worry. If he asks, just tell him I said so.”

The young doctors exchanged glances, but they were eager to try.

That was Evan's solution.

He had no other skills; all he knew how to do was treat patients. He didn't know how to handle the people side of things. But wasn't there someone who did? Leo Cao was better at working his connections than anyone Evan knew.

And he happened to be one of the people in charge of the academic center. Perfect! The hospital leadership really had thought of everything, putting a man with that talent on the team!

These youngsters were all devoted fans of Dr. Xu. They followed his instructions to the letter. Now that he'd taken care of their worries, what was there to be afraid of?

So the young doctors immediately began making a sweep of the building.

They went through the inpatient wards, room by room. Never mind which department a patient belonged to—the Chinese medicine team was covering everyone today!

The inpatient building suddenly came alive.

They followed Evan's instructions faithfully: make an initial assessment using the other examination methods, check it by asking questions, then combine the findings from all four methods and write down the resulting pattern assessment.

They split up to do it. For each patient, they recorded the room number, bed number, and name. When they were finished, they would get together to compare their answers and discuss their conclusions. Anything they couldn't agree on or weren't sure about had to be marked for a teacher to review.

Even working separately, they sometimes ended up at the same bed. Fine, then—they could do it together, one on either side, each taking a pulse at the same time.

Pulse examination took care and attention. The doctor needed a quiet mind, and the patient needed to be still. Take a rapid pulse, for example: six beats in one breath, coming and going quickly, roughly 90–100 beats per minute.^[4]

If a patient had just jogged in from outside, the pulse would be fast, making an accurate assessment impossible at that moment. That was why patients needed a little rest before their pulses were examined.

These inpatients were ideal. They mostly stayed in bed rather than going anywhere. And they were lying down—the best position for pulse examination, with the pulse qualities easier to distinguish.

There could hardly be better patients for the young doctors to practice on.

Reader Notes

Reader Notes

1. ↩︎ The four examinations. Chinese medicine traditionally brings together inspection, listening and smelling, inquiry, and palpation. Looking at the tongue belongs to inspection; feeling the wrist pulse belongs to palpation. Inquiry supplies symptoms and relevant history. Here, Evan tells the doctors to form an initial assessment before asking questions, then compare it with what the patient reports. That sequence is his teaching exercise in the story, rather than a requirement built into the four methods themselves. Source: Hong Kong Polytechnic University — Four Diagnostic Methods.
2. ↩︎ Pattern assessment. Pattern differentiation, or bianzheng, means drawing together clinical findings to identify the nature and context of a patient's condition within Chinese medicine. It differs from simply assigning a disease name. The young doctors are writing their provisional conclusions as a learning exercise. Evan explicitly separates that exercise from showing patients the conclusions or independently prescribing treatment; the chapter does not turn their worksheets into treatment orders. Source: WHO — Traditional Chinese Medicine Terminologies, entries 550–553.
3. ↩︎ Learning with a clinical mentor. Genshi means learning alongside an experienced clinician through observation, discussion, and supervised practice. It need not mean a formal master–disciple initiation or a particular academic qualification. Cao's role here is to help organize that learning. Evan stretches the description to make handling other departments' objections part of Cao's responsibilities, which is the joke. Source: National University of Health Sciences — Apprentice-Style Learning in Acupuncture and Herbal Medicine.
4. ↩︎ Breaths, beats, and rest. The traditional six-beats-per-breath description appears in the Binhu Maixue. WHO's terminology uses more than five beats per breath for a rapid pulse. A breath is not a fixed unit of time, so it does not yield a universal beats-per-minute conversion. The novel's approximate 90–100 figure is retained. Recent exertion can affect pulse rate; the narrator's further claim that lying down is best for discerning pulse qualities remains the story's assessment. Sources: Binhu Maixue — Rapid Pulse (Chinese primary-text transcription); WHO — entry 892; MedlinePlus — Pulse, preparation and exercise.