Path of Medicine With a System

Zhang Fan read over countless medical reports on his first morning in the hematology department. He almost finished the entirety of the last two years’ worth of medical reports in hematology.

The other doctors in the department, particularly the rotation doctors, were really curious what Zhang Fan was doing. They were really envious of how fellow rotation doctor Zhang Fan didn’t have to do any work at all. However, they then saw that Zhang Fan was sitting at a computer for an entire morning without even moving. They were really impressed by this! They kept sneaking glances to see exactly what Zhang Fan was doing.

This was simply human nature. Nobody would be curious about what someone unknown was doing. However, they would all wonder what someone well-known was doing. This was just far too common. Maybe it was human nature to admire the strong?

The majority of patients in Chasu City Hospital’s hematology department had anemia. There were all sorts of different types of anemia. These patients were mostly younger women. There were also a few patients who had purpura for various reasons. The cause of the purpura would be unknown even by the time that such a patient was either discharged or even died.

The biggest trait of the hematology department was that most diagnoses were uncertain. The preliminary diagnosis written on medical report would always have a question mark at the end. Even the final diagnosis would still have a question mark. This wasn’t because of any particular rule. These were real question marks because the patient’s vitals and the available laboratory examinations didn’t support any currently known diagnosis.

A medical report which didn’t have a confirmed diagnosis would be considered a failure. However, there really was no helping it. Doctors in the hematology department could only make their best guesses! This wasn’t because hematologists were irresponsible. Countless basic blood diseases were impossible to diagnose. They also had unknown causes.

Graduate student Zang Bing was a rotation doctor currently in the hematology department. He had a master’s degree in nephrology. Graduate students would have it much easier compared to undergraduate student rotation doctors. Graduate students would only need to rotate through a few departments which were related to their main field of study.

Graduate students would have already signed a contract with the hospital when they were hired about what department they would be permanently assigned to in the end. That was why graduate student rotation doctors felt significantly less pressure. Not only that, graduate students were still considered quite valuable in the year 2011 in China. The hospital would even pay for their housing expenses, which reduced their financial pressure as well.

Zang Bing was really energetic. He was writing a medical report on the computer next to Zhang Fan’s. When Zang Bing saw how Zhang Fan hadn’t moved for the entire morning, he couldn’t help but exclaim, “Doctor Zhang, this won’t do with how you’re acting. You’re giving us so much pressure. You see, before you joined the department, the rotation doctors were still chatting and laughing. But since you haven’t moved for the entire morning, we don’t dare to get up, either!”

“Oh! Isn’t that a bit of an exaggeration? I’ve never studied hematology before. I’m also not a graduate student. That’s why I was so absosrbed in my studying. The diseases in this department are truly complex.”

“Hey! You’re overestimating us graduate students. To be honest with you, having three extra years as a graduate student is just working as a slave at a large hospital for three years. There’s nothing grand about it. As for the diseases in the hematology department, I think that even doctorate degree students would have trouble, much less graduate students!” Zang Bing kept typing his medical report while also chatting with Zhang Fan.

Zhang Fan studied the hematology department’s diseases for the entire morning. He roughly categorized them into three different types, based on diseases for red blood cells, white blood cells, and blood platelets, which were known as the three blood vessel brothers. The most important cells in the blood were these three types. Of course, there were also other cells in the blood, but these three were understood the best. The other types of blood cells still hadn’t been researched enough to be understood well!

Blood was everywhere in the human body. Blood circulatory system was incredibly complex. Describing how blood worked in detail would be at the length of a thesis. Not only would normal people not understand such a thesis, even a doctor who wasn’t a hematologist likely wouldn’t understand it, so let’s just go with a simplified explanation of blood.

Red blood cells were just like shipping workers inside the body. They would transport oxygen to every part of the body, and then take away the carbon dioxide.

White blood cells were like the defenders of the human body. They would attack and kill any invading germs or viruses.

The blood platelets were like fixers. They would happily travel through all the blood vessels and then joyfully fix anything that had a problem with it.

A certain king of England had a certain genetic disease from inbreeding. His blood coagulation factor had a problem, which meant that his blood wouldn’t clot and he would have major bleeding if he wasn’t careful! This was no laughing matter at all. Blood not clotting properly meant that if your lover accidentally kissed you too hard during a moment of passion and caused your tongue to bleed, it would be possible to bleed to death just from such a minor injury! That was the scariness of having a blood coagulation factor problem.

Anemia was actually caused by a lack of red blood cells. If one’s body didn’t have enough red blood cells, then the body would lack oxygen, leading to dizziness, an uncomfortable sensation, and discomfort in many parts of the body. There were many different types of anemia too.

Young women were the most susceptible to anemia. A young woman who didn’t eat enough, leading to insufficient nutrition, and a young woman who had heavy bleeding from periods were two of the most common anemia types. Treating anemia wasn’t something that could be easily done just with some medicine. Treating anemia would be a very long and gradual process.

For instance, if a young woman was anemic due to heavy bleeding from her period, and she didn’t have any gynecological disease, then one of the best methods for treating her anemia would be to have her eat more animal livers, dark leafy greens, and tofu.

On the next morning, the hematology department held its daily morning meeting where the department’s work was arranged. Director Li Qing then clapped her hands after arranging the work, and told all the hematology department personnel, “I have something to tell everyone. This is Zhang Fan, Doctor Zhang. I think that everyone already knows who he is already. He’s going to be on rotation in our department for one month.

“Doctor Zhang, how about you say something?” Director Li Qing said to him slightly teasingly.

Zhang Fan hurriedly smiled and waved his hand.

“Alright, since Doctor Zhang won’t say anything, let’s begin today’s work. Ruan Yuan, you team up with Doctor Zhang.”

“Okay, Director!” Doctor Ruan replied in a clear voice. Ruan was a relatively rare last name in China. Ruan Yuan had just turned 30 years old. She had also just been promoted to attending physician. She had gotten married two years ago, but she didn’t have any children yet. She was a hardworking and pretty woman. Her husband was a government secretary, although he wasn’t a government leader’s personal secretary.

“Doctor Zhang, let us begin the patient checkups, then?”

“Sure, Doctor Ruan.”

Since it wasn’t Monday, there was no need to do a major departmental checkup on all the patients. The hematology department had fewer patients than most departments, so Ruan Yuan also had few patients. She only had three patients in total. Two of her patients had anaphylactoid purpura, while one had anemia due to iron deficiency.

Both patients with anaphylactoid purpura had classical examples of the disease. Purpura appeared all over their bodies, especially the back, thighs, and shins. It was as if they had dyed themselves purple.

One anaphylactoid purpura patient was an adult, while the other was a child. The adult patient was a 28-year-old small business owner from inland China. He was in the renovation business, and he did the work himself. Since the Spring Festival was now over, the government had stopped supplying heating[1], which meant that it was the busy period for renovation in Chasu City.

He worked a little too hard on multiple renovation projects at once, causing problems to appear in his body.

“Doctor Ruan, what symptoms did the small business owner have that caused him to visit the hospital?”

“Him?” Ruan Yuan and Zhang Fan walked in the hallway towards her office as she recalled the symptoms. “His family brought him over when I was on duty sometime in the middle of last month. At that time, he had such a severe nosebleed that it kept bleeding through all the toilet paper stuffing his nose. He then started having a fever after he was hospitalized. It was almost impossible to detect any blood platelets in his body at that time. I immediately categorized him as being in critical condition.”

“What about after that?” Zhang Fan inquired.

“After he was hospitalized, I prescribed antihemorrhagic medication for him, along with blood transfusion. Even after many different examinations, it was still impossible to find the specific cause of his condition. He had so many blood platelets transfused into him, but his condition didn’t improve at all.”

With some fear with what had happened previously, Ruan Yuan then said, “His family members were so angry with me, yet it was impossible to clearly diagnose him. His condition at the time was so severe that it would be impossible to transfer him to another hospital. He would never make it to Raptor City successfully by car. A few jolts on the road would likely cause major internal bleeding for him. No flight attendant would possibly allow him to fly by plane with so much purpura all over his body. Thus, his family spent so much on medical fees every day, yet his condition wasn’t improving at all.

“Everyone in our department treated him together for more than two weeks. Our Director Li already contacted an expert doctor from the provincial hospital. Just as the expert doctor was about to come over, the patient’s condition started improving and his blood platelets started gradually increasing.”

“What was the cause of his condition, then? Was that ever discovered in the end?” Zhang Fan then asked as they walked together.

“There’s nothing that can be confirmed for certain. However, the patient’s family started treating me much better since his condition improved, and I was also able to ask the patient regarding his medical history.”

Ruan Yuan then looked all around her before she whispered to Zhang Fan, “I think his bleeding was actually caused by the nature of his work. He didn’t wear any personal protective equipment at all while renovating. He worked with all sorts of paint, glue, and other chemicals, which is the most likely cause of his bleeding that had no apparent reason.”

She then continued as if she was worried that Zhang Fan wouldn’t believe her. “Last year, a female coworker of my husband was in a hurry to move into her new home that had just finished renovating because she was past 30 years old already. She then got married and became pregnant. Can you guess what happened after?”

“What happened?” Zhang Fan asked. He wasn’t interested in gossip here. He was interested in learning what had happened in a medical situation as a way to learn more experience.

“A few months after she got pregnant, one day, she suddenly started feeling pain in her abdomen while at work. Her coworkers hurriedly took her to the hospital. The checkup revealed that her fetus was deformed!”

“Sigh!”

“What happened was truly heartbreaking. Both husband and wife were getting older. They finally had a child, yet the fetus was deformed. Both of them cried so much in front of the gynecology and obstetrics department. That’s why, honestly, it’s better to just renovate as simply as possible! There are so many problems with Chinese renovation companies nowadays! If you really want a new house, it’s best to let it air out for at least half a year! An entire year would be better!” Ruan Yuan recommended to Zhang Fan.

“What about the child patient with anaphylactoid purpura? What happened with him?”

“Oh, you mean that little fatty? Ha, his parents are too busy with work to take care of him. He’s only in his second year of elementary school, yet he’s already so fat that he can barely walk. His parents are so terrible. They only care about making money. They give their son 50 yuan every day for eating and drinking whatever he likes. The kid just eats food from outside every day. What does he even understand at his age? He always drinks soft drinks and he always buys all sorts of junk food from food stalls around his school whenever he’s hungry.

“The end result was that either because of some dried tofu or fried spicy sticks that he ate for lunch, the boy didn’t know which, he started having a fever and becoming delirious later that afternoon in class. This was followed by large patches of purpura appearing all over his body. When he was brought to the hospital, he looked just like a round meatball covered in purple dye. His head teacher was a really young woman who was so scared that she didn’t even remember how to talk anymore.”

“Oh, I can see that he still has a little bit of purpura.”

“This is nothing at all. He’s already recovered. You didn’t see what he looked like on his first day here. That was truly a frightening sight.”

Ruan Yuan and Zhang Fan arrived at her office as they chatted. They then saw Wang Yanan and Jia Suyue waiting for them there. The two women were really surprised to see Zhang Fan. Jia Suyue’s face suddenly became bright red! She immediately pulled Wang Yanan with her and tried to leave!

Wang Yanan was also feeling somewhat awkward! She directly asked Zhang Fan, “How come you’re at the hematology department?”

“Why do you think? I’m on rotation here. What are you two doing?” Zhang Fan asked in confusion.

“I’ll talk to you later. I need to drag Jia Suyue back here first!” Wang Yanan then chased after Jia Suyue!

“Oh!”

[1] TL/N: In China, heating is controlled by the government and shut off at a certain date each year.