Chapter 20: Just Good Luck

The two exchanged contact information, and after Xu Qiushuang gave her phone a little wave, she turned and left. Judging by her retreating figure, she seemed to be in a very cheerful mood.

Fang Zhiyan, however, could only let out a sigh. He understood how she felt, but he had nothing to his name—he was barely scraping by just to make ends meet. Once he finally obtained his practicing physician’s license, perhaps he would be able to earn more money.

Fang Zhiyan returned to his rented room and quickly tidied up.

The next day was another standard morning shift. When Fang Zhiyan arrived, Zhu Zixiao was already waiting in the office.

"Little Fang, what’s going on with you? Why do you always arrive exactly at the last second?" Zhu Zixiao couldn't help but grumble. "You don't have a shred of our enthusiasm for work."

Fang Zhiyan grinned. "Clocking in at the last possible moment is a skill, not everyone can do it. You should try it sometime."

"Really?" Zhu Zixiao paused, looking skeptical. "Why would I want to try that? If an emergency patient comes in, I’d at least be here to lend a hand."

No sooner had the words left his lips than someone from the adjacent emergency ward shouted, "Dr. Cao, come quickly! The patient in bed two is complaining of pain again."

Hearing this, Fang Zhiyan looked over to see the nurse, Shen Qingyue, calling out. Cao Chong rushed inside immediately. Fang Zhiyan glanced at Zhu Zixiao. How was it that his mouth was always such a jinx? There was never anything going on, but the moment he spoke, a patient would inevitably appear.

Fang Zhiyan sighed and quickly followed Cao Chong into the ward.

The patient was a young woman, drenched in cold sweat from the pain. Her face was pale, and she clutched her abdomen tightly, as if she could no longer endure it. Cao Chong was becoming visibly flustered.

"She’s already had three doses of Dolantin; how can the pain still be uncontrollable?" he muttered to himself, his brow furrowed.

Fang Zhiyan took the opportunity to observe the patient’s condition. The patient preferred firm pressure on her abdomen, which suggested it wasn't a case of hemorrhage or acute inflammation. Yet, the pain was so severe that even Dolantin couldn't suppress it, indicating an intense level of agony.

Cao Chong was at his wit's end. Gritting his teeth, he turned to Shen Qingyue. "Go and call Director He."

Shen Qingyue nodded hurriedly and left. Meanwhile, Fang Zhiyan observed the patient closely and asked Cao Chong a few questions. At this point, Cao Chong was helpless and could only converse with Fang Zhiyan.

The patient had first developed abdominal pain two days ago. The onset was sudden and the pain was severe, yet examinations showed no obvious positive signs. After the pain began, the patient had experienced multiple episodes of dark red bloody stools, with no mucus or pus present. Furthermore, an abdominal CT scan had already ruled out conditions such as mesenteric vascular thrombosis.

If that was the case, why was the pain so excruciating? Something felt off. Fang Zhiyan lowered his head, pondering deeply.

At that moment, the Deputy Director of the Emergency Department, He Dongfang, hurried over. "What’s the situation with the patient?"

Cao Chong explained the patient's condition briefly, his expression distressed. He Dongfang frowned. "What should we do then? Should we perform an exploratory laparotomy?"

"But the patient doesn't show clear surgical indications; that certainly won't do."

While the two were deliberating, Fang Zhiyan asked from the side, "Has a gastrointestinal endoscopy been performed?"

Cao Chong paused and explained, "The pain is too severe; it's impossible to perform."

"Has the patient eaten anything?" Fang Zhiyan continued.

Cao Chong shook his head.

"Nothing at all?" Fang Zhiyan hesitated, lost in quiet thought.

He Dongfang squinted at him and asked, "Do you have any ideas? Let’s hear them."

"I think it might be caused by taking oral amoxicillin for pharyngitis," Fang Zhiyan explained slowly.

Cao Chong rolled his eyes. "What does that have to do with anything? Fang Zhiyan, don't just spout nonsense."

However, before Cao Chong could finish, He Dongfang held up a hand to stop him. "Don't be so hasty. You don't have any better ideas, so why not hear what he has to say? I was the one who recruited him personally; he has some ability."

"Go on," He Dongfang prompted. He held this young doctor in high regard, especially since the time he had dared to defy hospital discipline to save a life.

"I think the patient should take oral lactobacillus preparations."

He Dongfang turned to Cao Chong. "Has this patient taken amoxicillin?"

Cao Chong was taken aback and nodded slowly. "The patient took amoxicillin herself a week ago for throat discomfort, but the abdominal pain only started three days after she stopped taking the medication."

He Dongfang frowned, silent.

Fang Zhiyan continued, "Reports of antibiotic-associated hemorrhagic enteritis have existed abroad since the 1970s and 80s. It is primarily caused by oral amoxicillin and penicillin derivatives. It could be an idiosyncratic toxic reaction, or the intestinal mucosa might be highly sensitive to the drug."

"If I remember correctly, the clinical manifestation is intense abdominal cramping."

He Dongfang paused, his gaze fixed on Fang Zhiyan. "This...?" He was uncertain about Fang Zhiyan’s claim. It sounded somewhat plausible, but even He Dongfang felt a bit confused. Was it really that simple?

"How can you be sure?" He Dongfang couldn't help but ask.

Fang Zhiyan thought for a moment, then looked at the patient. "Wait a little longer. After taking the oral lactobacillus, the patient’s pain should subside."

He Dongfang hesitated, then turned to Cao Chong. "Do as he says."

"Director?" Cao Chong was puzzled.

"Do as he says," He Dongfang repeated. "What he says makes a certain amount of sense. I believe I have read similar literature myself."

Cao Chong paused, then quickly acted on Fang Zhiyan's instructions. After the treatment, they stepped outside the ward with the patient’s family to discuss the condition once more.

Ten minutes later, Shen Qingyue emerged from the ward. "Director He, Dr. Cao, the patient has fallen asleep; the pain has subsided."

Everyone exchanged glances, their eyes filled with amazement. Fang Zhiyan had actually managed to resolve the issue. Just as he had said, the patient was indeed suffering from antibiotic-induced hemorrhagic enteritis.

"Little Fang, you are truly impressive." He Dongfang nodded with satisfaction, looking at Fang Zhiyan with even more gratification. He was worthy of being someone he had recruited personally; he hadn't expected him to be able to diagnose such an obscure condition.

Cao Chong was also awestruck. "I never imagined you would be right. Your theoretical knowledge is probably even more extensive than mine."

Fang Zhiyan said modestly, "Not really, I just happened to read some similar literature these past few days. It was just good luck."

He Dongfang waved his hand slightly. "No need to be modest; luck is also a part of ability. Besides, not everyone bothers to read those journals."

As he spoke, He Dongfang sighed. "Keeping you as an intern is truly a waste."