Chapter 14

The close contacts had identical symptoms. Tang Feiwan suspected a contagious disease and immediately applied for isolation treatment, requesting consults from the infectious disease and respiratory medicine departments.

In the isolation ward, a nurse drew Zhou Wenyun’s blood. Tang Feiwan, Lin Ye, and several other doctors held a consult in the small conference room outside. First, they reviewed the patients’ histories. Zhang Yan’s primary physician from general internal medicine spoke: “Our department had no reports of colds or fever, so it’s probably not very contagious.”

The associate director of infectious disease asked, “Any history of bird exposure?”

The general internal medicine physician replied, “I already ruled that out during the initial consultation. Zhang Yan is a neat freak. No animals at home, and no recent bird contact.”

A respiratory medicine attending physician brought up a special case. “Last winter, we admitted a patient with no bird contact history either. We treated him for ordinary pneumonia until we finally discovered it was psittacosis. Guess how?” He paused for two seconds. “The patient liked the smell of duck feathers and often went to the market to watch the butchers kill ducks.”

The general internal medicine physician raised a question. “But with psittacosis, the patient’s white count usually isn’t this high, right?” One reason he had initially ruled out psittacosis was that the patient’s WBC was as high as 17 x 10^9/L, which pointed more toward bacterial pneumonia.

Lin Ye suggested, “Should we do an mNGS?”

The infectious disease and respiratory doctors agreed.

Tang Feiwan said, “I called the family, but he’s not willing.”

“Money?” Lin Ye had happened to pass by when Zhou Wenyong was arguing with her earlier, so she had a general idea of the patient’s concerns.

Tang Feiwan nodded. “Mm. He also wants to transfer to another hospital, saying a community clinic can treat it too.”

The infectious disease associate director snapped, “Isn’t that gambling with the patient’s life?”

Lin Ye turned to Tang Feiwan, whose brows were tightly knit. “Is Zhang Yan conscious?”

“She’s conscious, but no urine output since this morning. Kidney damage has begun.”

Lin Ye considered for a moment. “First, have Zhou Wenyong come to the hospital to talk. If that doesn’t work, speak directly with the patient.”

The doctors discussed a plan to provide symptomatic treatment for Zhang Yan and stabilize her vitals. As for Zhou Wenyun, they’d wait for her test results.

At nearly 4 p.m., Zhou Wenyun’s blood results came back. A nurse took the report to the office. “Doctor Tang, Zhou Wenyun’s results.”

Lin Ye also moved over. Tang Feiwan took the report, but not before glancing sidelong at the person now close to her. She didn’t linger, turning back to the report.

White blood cell count normal. Neutrophil count normal. Zhou Wenyun had obvious chest pain and a fever over 39°C, so Tang Feiwan had also ordered a myocardial enzyme panel. The results showed lactate dehydrogenase and creatine kinase were markedly elevated, dozens of times above normal.

Myocardial injury during the acute phase of infection. Without timely intervention, Zhou Wenyun risked fulminant myocarditis. Considering the progression of the girl’s condition, Tang Feiwan suddenly shot up from her chair, grabbed the report, and rushed out. Lin Ye, behind her, felt as if she were seeing her younger self.

Back then, she was cool and driven in study and work, even a bit pushy.

Lin Ye shook off the trance, and reason returned. She hurried after Tang Feiwan.

They were still on the way when a nurse from the isolation ward rushed over. “D-Doctor Tang! Zhou Wenyun in the isolation ward is in ventricular fibrillation!”

Tang Feiwan and Lin Ye ran to the ward. Fortunately, the rescue was timely. Two or three doctors performed chest compressions and defibrillation. Three minutes later, Zhou Wenyun stabilized. Tang Feiwan immediately examined the girl, gave orders, and had the ward physician and nurse monitor her closely before leaving.

Outside the ward, she removed her mask and leaned against the wall, breathing heavily.

Being a doctor meant facing death at any moment. They tried to restrain their emotions and avoid over-empathy, but that didn’t mean being cold-blooded. Tang Feiwan couldn’t imagine how a life that had been so vibrant just hours ago had nearly slipped away before her eyes.

“Here.” A bottle of water appeared before her. Tang Feiwan reached for it. She knew the person standing beside her, wanting to comfort her, was Lin Ye. But her mind was full of the patient inside, so she only said softly, “Thanks.”

“Zhou Wenyong is in the consult room. Let’s go talk to him.”

“Mm.” Tang Feiwan opened the bottle, tilted her head back, and took two small sips.

The so-called consult room was a private space in the emergency department for talking with patient families. They pushed open the door and saw the family member sitting in a chair, legs crossed, face full of impatience. Zhou Wenyong looked up when they entered, and without preamble, stated his intention: “Doctors, I want to check my mom and my sister out.”

Tang Feiwan thought she’d misheard. “What?” She had already explained the severity of Zhou Wenyun and Zhang Yan’s conditions to him. How could he still want to discharge them?

Zhou Wenyong said, “I called the community hospital. Their doctor said they can take them. A couple of days of IV fluids and they’ll be fine.”

Tang Feiwan was furious. “Five minutes ago, Zhou Wenyun went into ventricular fibrillation and nearly died in the ward. Now you’re telling me you want to transfer her to a community hospital?”

Zhou Wenyong smirked. “You’re just trying to make money, scaring me. My sister’s always been healthy.”

Lin Ye handed him the test results, her tone calm but firm. “As doctors, our job is to inform you, the patient’s family, of her condition without reservation. The choice is yours. However, I must emphasize that once the patient leaves our hospital, any subsequent problems are not our responsibility, because we have followed normal treatment procedures and fulfilled our duties.”

Zhou Wenyong picked at her words. “I don’t understand any reports. But you say you’ve done your duty. Why couldn’t you find the cause in six or seven days?”

Tang Feiwan pushed Zhou Wenyun’s report toward him. “We have new findings today. We’d like your input.”

“What findings? What other tests?”

Tang Feiwan explained patiently, “Zhang Yan has a high fever and high white count. The bronchoscopy sputum sample showed inflammatory cells. Combined with the CT, it’s consistent with bacterial pneumonia. But your sister Zhou Wenyun also has a high fever, yet her white count and neutrophils are normal. Her CT shows mild pneumonia, meaning her lung damage isn’t severe. But her myocardial enzyme panel shows serious heart damage, which just triggered a malignant arrhythmia. So we suspect a contagious disease and recommend an mNGS test for confirmation.”

Zhou Wenyong grew more impatient. “I told you I can’t read reports. Now I can’t understand you either. Just tell me, how much does the test cost?”

Lin Ye, having been at the Second Affiliated Hospital longer, knew the price. She replied, “The mNGS test is more expensive than others…”

Zhou Wenyong jumped at the word “expensive.” “I knew it! You just want money!”

Seeing him shout at Lin Ye, Tang Feiwan’s protective instinct flared. Her attitude shifted 180 degrees, her tone hardening. “You want a transfer? Fine. Transfer now.” She stood and signaled Lin Ye to follow, then added over her shoulder, “I’ll write the transfer order in my office. Pay the fee and you can take the patient away.”

“Doctor Tang.” Lin Ye looked up and saw the sharp look behind Tang Feiwan’s glasses, clearly angry. She tugged at Tang Feiwan’s sleeve.

Tang Feiwan was indeed angry at Zhou Wenyong’s attitude, but she still cared about the patient. Thinking fast, she changed tack. She lowered her voice. “I’ll count to three.”

“Mm?”

“One, two…”

Before she could say three, Zhou Wenyong called out, “Uh, doctor, that test you mentioned. Do it.”

Tang Feiwan turned back, solemnly. “mNGS. Pathogen metagenomic next-generation sequencing.”

Zhou Wenyong wrung his hands, having made his decision. But like other family members, he wanted to know if the money was worth it. “What if the test still can’t diagnose it? You have to guarantee me something.”

“Sorry, medicine has uncertainties. Doctors can’t give patients guarantees. Even the most skilled surgeons can’t promise a 100 percent success rate.” Lin Ye nodded slightly. “But we will do our utmost to treat the patients.”

Back in the office, Lin Ye realized what Tang Feiwan had done. “That was a provocation tactic?”

“Yes. I realized that although Zhou Wenyong cares about money, he still cares about his family. For example, the 20,000 yuan for Zhou Wenyun’s art training camp came from him.” Tang Feiwan bent to organize the reports on her desk when she bumped a green art folder. It fell to the floor.

Lin Ye asked, “What’s this?”

“Zhou Wenyun’s art folder. She was still drawing while staying in the ward two days ago.” Tang Feiwan crouched to pick up the folder and the loose papers. Her gaze suddenly stopped. Lin Ye followed her line of sight and saw a dozen bird sketches scattered on the floor…