"Misdirection?"
Zhang Ming raised an eyebrow, casting a wary glance at Xia Tian.
This young man better not drag me into trouble.
A misdiagnosis, depending on the outcome, could range from trivial to catastrophic. If caught early, no harm done. But if it delayed treatment and endangered the patient, the hospital would bear responsibility. At fifty, with just ten years until retirement, Zhang Ming wasn't about to jeopardize his career over an intern's hunch.
"You're saying this isn't appendicitis? Then what is it?"
Xia Tian replied swiftly, "Just a moment, Director."
He sprinted out of the ER and tracked down the patient's boyfriend, bombarding him with rapid-fire questions.
"Does she often suffer from diarrhea or constipation?"
The young man nodded. "Yeah. We never cook—always order takeout. She loves spicy food and occasionally gets the runs."
"It's been happening more frequently these past few months, but nothing too serious. What does that have to do with appendicitis?"
Bingo.
Just as Xia Tian suspected.
He reassured the boyfriend quickly, "We now suspect this may not be appendicitis. Further testing is needed. But don't worry—she's stable now and out of immediate danger. Just wait here for the results."
He darted back into the ER.
"Director," he said firmly, "I suspect the patient has colon cancer. We need to do a colonoscopy and get a specialist consultation immediately."
Colon cancer?
The room fell into stunned silence.
"From appendicitis to colon cancer?"
"That's quite the leap..."
"Tian-ge, are you serious?"
The ultrasound clearly showed an inflamed appendix. Combined with her abdominal pain, all signs pointed to acute appendicitis. Where was this cancer theory coming from?
Xia Tian explained, "Early-stage colon cancer presents with abdominal pain, diarrhea, and irregular bowel movements. I just questioned her boyfriend—she meets all the criteria."
"And her white blood cell count is normal. No signs of infection. That rules out appendicitis."
"As for the swollen appendix, it may be a secondary effect caused by the tumor in the colon."
The room was dead silent.
Everyone looked to Zhang Ming.
The final decision was his to make.
One side was the patient.
The other, his most promising protégé.
3 seconds of deliberation.
"Prep for another abdominal ultrasound," Zhang Ming commanded. "I want to take a closer look at the appendix. And get Director Qian from Colorectal Surgery down here for a consult."
"Ready the colonoscopy."
The ER buzzed into motion.
Zhang Ming personally performed the ultrasound. He trusted Xia Tian—but trust didn't mean skipping due diligence. If this was appendicitis and it perforated, the consequences could be deadly.
"No signs of perforation," he finally said. "She can wait. Proceed with colorectal examination."
A colonoscopy normally required a three-day prep period—soft food, fasting, and a bowel-clearing laxative. But emergencies couldn't wait.
Two nurses worked in tandem to fast-track her gut cleanse.
Moments later, Director Qian arrived.
In his early forties, with boyish good looks and a dazzling white smile, Qian was the poster doctor of the provincial hospital. When he entered the ER, it felt like spring itself had walked in.
"Someone called me for an emergency consult just as my lunch arrived," he said, grinning. "But the moment I heard Director Zhang's name, I ditched the food and rushed over. Food can wait—Director Zhang cannot."
They were old colleagues. Zhang Ming, a senior figure at the hospital, was well-respected, especially by younger doctors.
Zhang chuckled. "I haven't eaten either. Once we're done here, lunch is on me."
"I called you in for a patient complaint of abdominal pain. Here's the ultrasound."
Director Qian took the report. No need for elaborate context—one look at the scan would tell a seasoned doctor all they needed to know.
After a quick glance, he chuckled.
"Looks like textbook appendicitis to me. You needed me for this?"
Zhang Ming nodded solemnly. "That was my initial thought too. But my intern suspects it's a misdiagnosis—he thinks it may be colon cancer."
"Your intern?" Qian raised a brow and scanned the room until his eyes landed on Xia Tian. His expression brightened.
"Well, if it isn't the famous intern Xia Tian," he said with a laugh. "The social media star of our hospital—I've seen your videos. Bold and meticulous. Not bad."
"But... diagnosing colon cancer just from diarrhea? That's a stretch."
"She's only twenty-five. Most young people eat junk every day. Diarrhea's practically a lifestyle choice. That doesn't mean cancer."
Qian was smiling, but clearly unconvinced.
Xia Tian, calm and composed, didn't argue.
"Well, you're here now. Let's take a look together," he said.
The nurses were ready. The colonoscope—a 130cm flexible fiber-optic tube equipped with a camera—began its slow journey into the colon.
Everyone watched the live imaging.
Zhang Ming and Qian kept up their usual banter.
"There's a new Haidilao at Joy City," Qian said. "You like hotpot, right? My treat. Bring your intern too."
"I'm on the day shift today," Zhang replied. "No alcohol, but after work—I'm in."
"Wait—hold on!" Zhang suddenly shouted. "Back the scope up a bit."
The camera shifted.
There, on the monitor, was a small, blackened mass clinging tightly to the colon wall. Tumorous. Clearly malignant.
"Qian—did you see that?"
"I did."
Qian pushed up his gold-rimmed glasses, his expression now grave.
"The tumor's already turned black. We'll need a biopsy immediately. But... yes."
"This is colon cancer."
In that moment, every eye in the room turned to Xia Tian.