Chapter 63 Worse Than Before!

A chance at another special reward brings Evan to Simon’s outpatient consulting room.

Evan was a little surprised.

The last time he'd received a special reward, the system had let him enter the clinical training room. There, he had studied acupuncture under Dr. Cheng.

Two visits had taken him from a complete beginner to the standard of a provincial expert. He had even mastered Setting the Mountain on Fire and Heaven-Penetrating Coolness. True, he could only pull them off seventy percent of the time, but even the country's top acupuncturists only managed eighty percent.^[1]

Now he had another chance at a special reward. He couldn't help feeling excited.

Leo glanced at Evan's face, then said to Simon, “Dr. Xu still has to get back to work. He has things to do. Another time. Today isn't convenient.”

Simon's expression tightened. He frowned. “Not today? Well… ah… all right…”

“No, let's do it today,” Evan said.

“Huh?” Leo stared. “Didn't you say you had to hurry back to work?”

“I've already taken the morning off. Besides, discussing medicine is one of life's pleasures.”

Simon brightened at once. “Good, good! Then I'd be grateful for your guidance, Dr. Xu.”

“You're too kind.” With that polite reply, Evan went with him.

Leo stood there, baffled, for quite a while. Then he followed. He wanted to see what Simon was up to.

Evan followed Simon into his consulting room. They had barely entered when Leo pulled Simon back outside.

“What is it?” Simon asked.

“That's what I'm asking you.”

“I told you. To discuss medicine. Compare notes.”

Leo looked suspicious. “On what? Can't you discuss it with me?”

Simon smiled. “Come on. There isn't much to discuss at your level.”

Leo took offense at once. “How do you know he's better than me?”

“Isn't it obvious? Hadn't you been stuck with that patient for days?”

Leo had no answer. “Then what exactly are you trying to do?” he demanded irritably. “What do you want to discuss?”

Simon's gaze steadied. “I only want to prove one thing.”

“What?”

“That their whole approach is wrong!”

Leo looked confused. “Which approach?”

“Traditional Chinese medicine. All those theories about the five phases and yin and yang.”^[2]

Leo was taken aback. “Why would you want to prove that?”

Simon frowned, his voice turning serious. “Because I couldn't have helped that patient either. But he cured her. With one dose. Even modern medicine isn't that powerful.

“To be honest, I can't make sense of his approach. But it astonished me. So I want to discuss it with him again. I want to prove that he just happened to get lucky.”

Leo looked thoroughly disgusted. “What kind of person are you? What did Dr. Xu ever do to you? Why do you have to prove him wrong?”

Simon's frown deepened. “I'm not determined to prove him wrong. I only want to prove I haven't been wrong. I've spent nearly half my life doing things this way. I can't afford to be wrong.”

Leo was startled. “Then… you could have tried proving it with us.”

“I already have.” Simon left him with that and went back inside.

Leo stood at the consulting-room door, puzzled. “What's that supposed to mean?”

Simon sat down and began calling patients by number.

Evan sat beside him. Looking around the consulting room and breathing in the hospital's disinfectant smell, he couldn't help feeling nostalgic. It reminded him of his days as the expert Dr. Xu.

Leo stayed too, coming in after them.

Three doctors crowded into the little room. Patients were startled when they came in.

“I… I… I don't have something incurable, do I?” The patient went pale. Who ever saw so many doctors at an outpatient appointment? Especially when Leo and Simon both held the rank of associate chief physician. In this small county town, they were already leading specialists.

If all went as expected, Simon would soon take over as deputy head of the department. Then he really would be Director Liu, an expert in both title and position.^[3]

Simon hurried to reassure him. “It's all right. Don't be nervous. These two doctors have just come to discuss the cases with me. It isn't only you. It'll be the same for the patients after you.”

“Oh.” The patient nodded, still doubtful.

Simon inserted the patient's social insurance card into the reader and brought up his medical record.^[4] “Dr. Xu, have a look at his earlier test reports and treatment records.”

Evan nodded. “All right. You carry on.”

Simon began questioning the patient. “Have you finished the medicine? Have you taken anything else? What's still bothering you?”

“I only took what you gave me last time. It didn't do much. Now I feel even more sick, like I'm going to throw up. And food doesn't taste of anything.”

“Does it still hurt and burn when you urinate?”

The patient nodded. “Yes. It burns like fire. And whenever I cough, urine comes out.”

If you spot this narrative on Amazon, know that it has been stolen. Report the violation.

He took several quick breaths after speaking, as though a little short of breath.

Simon frowned and nodded. “Let's do some more tests. Another urinalysis and complete blood count.”

Just as he was about to send the patient for testing, he remembered Evan beside him. “Dr. Xu, have you finished reading the record?”

“Yes.”

“What do you think? Would you like to examine the patient?”

Evan frowned. “Shall I be frank?”

Simon paused, then smiled. “Of course.”

Leo glanced at Simon. Why did he get the feeling Simon was about to make a fool of himself? Even Dr. Raymond Liu, a city-level expert, had been shown up by this young man!

Looking at the earlier record, Evan said, “The patient reports frequent urination for one week, with burning and pain, accompanied by fever and a flushed face. Appetite fair. Urination and bowel movements normal.^[5] But why are there no tongue or pulse examination findings?”^[6]

Simon explained, “Aren't the urinalysis and blood count reports right below that?”

Evan fixed his eyes on Simon's, his tone becoming more forceful. “I'm asking why there are no tongue or pulse examination findings!”

The atmosphere in the room grew tense.

Simon's heart gave a sudden jolt. It felt like being back at school, unexpectedly called on by a strict old professor.

Then irritation rushed in. He was an expert, damn it. Agreeing to speak as equals with a youngster was already doing him a favor. And now the kid was acting so damned superior!

Simon frowned and held back his displeasure. “Because we already have the exterior pattern and the lab results. Tongue inspection and pulse qualities—that isn't scientific.^[7] It's only the pulse beating. There's no real significance to it. The tongue's the same.”

Now Evan understood why the system had given him this task. There was something wrong with this man!

“Then what was the basis for your prescription, Dr. Liu?” he asked coolly.

Simon's manner was no longer so friendly either. “Frequent urination, burning, and pain. A flushed face and fever as well. It's obviously a heat pattern. And look at his test reports. There's inflammation.

“Taking it all together, the diagnosis is heat strangury—what Western medicine calls an acute urinary tract infection. So I prescribed two medicines: Bazheng San and the Western drug nitrofurantoin.”^[8]

Evan gave a quiet snort. “Come on, Comrade. Stick out your tongue and let me have a look.”

The patient looked at Simon, bewildered.

“It's all right,” Simon said. “Just do as Dr. Xu says.”

The patient stuck out his tongue.

“Good. Now I'll take your pulse.” Evan carefully examined the pulse at both wrists, then took a pen and paper and briefly wrote down his findings.

Simon glanced at him a couple of times. “Dr. Xu, what's your diagnosis?” he asked, sounding displeased.

Once again Evan asked, “Shall I be frank?”

Simon chuckled. “By all means.”

“Send him for another urinalysis and blood count. The results will definitely be worse than last time!”

Evan tossed the pen onto the desk. This time, he really was angry.

Reader Notes

1. ↩︎ The two needle techniques. Setting the Mountain on Fire and Heaven-Penetrating Coolness are compound needling manipulations traditionally associated with warming and cooling. The names do not describe literal flames or supernatural cold. Here seventy and eighty percent refer to successfully performing the techniques within the novel's training framework, not clinical cure rates. Source: Beijing University of Chinese Medicine — Compound needling methods (in Chinese).
2. ↩︎ Yin, yang, and the five phases. Yin and yang describe relative, interdependent aspects of bodily functions and conditions. The five phases—wood, fire, earth, metal, and water—provide another traditional framework for relationships and change. They are not chemical elements. Simon is rejecting these explanatory frameworks; the argument belongs to the characters. Source: WHO — Chinese medicine terminology, entries 3 and 28.
3. ↩︎ Professional rank and a department post. Associate chief physician translates fu zhuren yishi, a senior professional title below chief physician. Deputy head of a department is a separate management position. The source plays on the shared word zhuren: Simon already has the professional rank but is expected to acquire an administrative post as well. “Director Liu” conveys that form of address without making him the department's chief. Evan's earlier “provincial expert” describes his fictional skill level, not an appointment to either post. Sources: China's National Health Commission — Medical professional title structure, section II(1) (in Chinese); Hubei Human Resources and Social Security — Title levels, article 2 (in Chinese).
4. ↩︎ The social insurance card. China's social insurance card can serve as identification for social insurance services and medical expense settlement. It belongs to China's public-service system and is distinct from the American Social Security card. In this scene Simon inserts a physical smart card before opening the patient's consultation record. The passage does not specify a particular national medical-record database, the patient's insurance benefits, or which information is stored on the card itself. Source: Ministry of Human Resources and Social Security — Social insurance card functions, section II (in Chinese).
5. ↩︎ A contradiction in the chart. The quoted record describes frequent urination and also calls urination and bowel movements normal. These statements conflict in the Chinese source as well. The passage does not explain whether the latter phrase was intended more narrowly.
6. ↩︎ Tongue and pulse findings. In Chinese medicine's four diagnostic methods, observing the tongue belongs to inspection; examining the pulse belongs to palpation. Pulse qualities include more than the number of beats. Evan is asking for those traditional findings, while Simon points to laboratory reports. Their dispute concerns the grounds for diagnosis; the tongue and pulse findings themselves are not specified. Source: Hong Kong Polytechnic University — Four Diagnostic Methods.
7. ↩︎ “Exterior pattern.” Biao zheng is a traditional category describing an illness at the exterior, distinguished from an interior pattern. It is not a general label for visible symptoms or abnormal laboratory results. Exterior/interior concerns where a disorder is understood to lie; cold/heat describes another aspect of its traditional classification. Simon invokes the exterior category here without specifying which observations establish it. Source: WHO — Chinese medicine terminology, entries 992–997.
8. ↩︎ Heat strangury and the two medicines. Re lin, rendered here as heat strangury, is a traditional category involving frequent, difficult, burning or painful urination in a heat pattern. Bazheng San is a named formula traditionally used for damp-heat urinary patterns; san identifies the formula name and does not settle its preparation in this case. Nitrofurantoin is an antibiotic used for urinary tract infections. Simon equates his traditional diagnosis with an acute infection. That equivalence is his explanation, not a claim that the two classifications are interchangeable or that either prescription has been independently validated for this patient. Sources: WHO — Heat strangury, entry 1690; Hong Kong Baptist University — Bazheng San, F00149; MedlinePlus — Nitrofurantoin.