Chapter 10: DR. AN'S STUDENTS
Tú Linh's group arrived early at the Oncology Department because today was the day they would have their patient charts corrected. Unlike previous sessions, they wouldn't be going from room to room today. Instead, Thanh An required each of them to complete a chart based on the patient they'd been assigned to follow. One chart per person—no copying from each other, no asking the person beside them, and absolutely no filling in blanks with vague half-memories just to make everything look complete.
Thanh An had made one thing clear from the start: she didn't need beautifully formatted charts. She needed accurate information backed by evidence. Five patient charts were arranged neatly on the desk. Thanh An sat at the head of the table and opened them one by one. She read very slowly, barely skipping a single line. At first, the group sat fairly comfortably, but the longer they watched her turn each page, the quieter the room became.
Quân was the first one called.
“Lê Minh Quân.”
“Yes?”
“What do you call this?”
Quân stood and walked to the desk. Thanh An pushed his chart toward him.
“Read the medical history you wrote aloud for everyone.”
Quân bent over and began reading. “The patient had abdominal pain for about three days before admission. The pain was severe, with no clear cause...”
“Stop.”
Quân fell silent at once. Thanh An pointed to the line he'd just read. “How severe is ‘severe’?”
Quân blinked. “The patient said it was severe.”
“Pain scale?”
“Uh...”
He fell silent.
Thanh An looked at him. “Did you ask?”
Quân lowered his head. “I forgot.”
“Then why did you write it down?”
Quân had no answer.
Thanh An picked up her pen and lightly underlined the sentence. “If you don't know, write ‘not assessed.’ Don't turn information you don't have into information belonging to the patient.”
“Yes.”
“And here.” She flipped to the next page. “You wrote that the patient had no history of drug allergies. How did you ask?”
“I asked the patient.”
“What did the patient say?”
Quân was silent for a few seconds before answering quietly, “The patient said they didn't remember.”
Thanh An looked up.
“Not remembering and having no allergies are two different things. You have to distinguish between them clearly, okay?”
“Yes.”
“Go back and revise this entire section until I can accept it.”
“Yes.”
Scratch. The pen dragged across the paper. Quân looked at his chart, then returned to his seat and stared at it. The chart he'd worked so hard on had been attacked by a whole bunch of slashes, and his expression had become much more serious. He no longer looked carefree.
Next was Khánh. Khánh's chart was fairly neat, and most of the sections were filled out. But Thanh An stopped as soon as she reached the vital signs.
“Nguyễn Gia Khánh.”
“Yes?”
“You wrote the blood pressure as 120 over 80.”
“Yes.”
“When was it measured?”
Khánh answered immediately. “When I entered the patient's room.”
“Pulse?”
“Yes.”
“Respiratory rate?”
Khánh froze.
“Uh...”
Thanh An looked down at the chart.
“Not there.”
“Yes.”
“Monitoring vital signs means monitoring the pulse, blood pressure, respiratory rate, temperature, and SpO₂. Those are what directly reflect physiological function and the patient's overall health. You didn't monitor carefully, so why does your vital-signs section look as though you performed a complete assessment?”
Khánh lowered his head.
Thanh An didn't speak harshly. She only said very slowly, “The numbers in a chart aren't there just to fill every box. When you record information, you need to know when it was measured, under what circumstances, and what it means. If you don't have the information, leaving it blank is better than making the chart look artificially complete.”
“I understand.”
“Go back, check again, do it again, and revise it.”
“Yes.”
Scratch. Another one got a page full of strike marks.
Khánh stared at the chart, blinking a few times before returning to his seat. Mai was next. Her chart was more careful than the previous two. The medical history was fairly detailed, and she'd asked most of the relevant questions. Thanh An read for a while, then used her pen to point to a passage nearly half a page long.
“Did you write this section down word for word?”
“Yes.”
“You don't need to write everything.”
Mai looked slightly startled. “I don't?”
“You're writing a patient chart, not transcribing an entire conversation. Keep the information that matters and cut the irrelevant details. A longer chart isn't necessarily a better chart.”
Mai nodded.
“Yes.”
“Your history-taking is acceptable for now. But you need to learn how to filter information.”
“I understand.”
Thanh An moved on to Trang's chart. Trang had been sitting up straight the entire time. Her chart didn't have any glaring errors, but Thanh An stopped again when she reached the final assessment.
“Trang.”
“Yes?”
“What did you base your conclusion on?”
Trang looked down at her writing.
“On the patient's symptoms and examination results.”
“Specifically?”
Trang fell silent. Thanh An used the tip of her pen to point to each line. “You documented this symptom. You documented this result. But what step took you from those two pieces of information to this conclusion?”
Trang couldn't answer, and Thanh An gave a small nod.
“That's the problem.”
She set down her pen.
“You've gotten into the habit of seeing a few signs and immediately jumping to the conclusion you read in a textbook, assuming the patient must have that disease. In reality, patients rarely present exactly one hundred percent like the descriptions in textbooks. Symptoms can be subtle, overlap between different diseases, or be affected by a person's physical condition and underlying illnesses. But in clinical practice, the important thing isn't guessing as quickly as possible based on a textbook. What's important is knowing what you're basing your assessment on.”
“Yes.”
“That’s why logical reasoning and clinical evidence are always more important—and safer—than guessing the right answer. If you don't have enough grounds, write that the evidence is insufficient, then perform the necessary diagnostic workup and tests before reaching a conclusion. You don't need to pretend to be certain.”
“Yes.”
Thanh An set Trang's chart aside. Finally, she picked up the last one. Tú Linh had been sitting quietly the whole time. She didn't know whether her chart was good or not. She only knew that Thanh An had been reading it longer than she'd expected. She turned through every page and paused at a few spots, but didn't speak right away. After a while, Thanh An finally called her name.
“Tú Linh.”
“Yes?”
“Come here.”
Tú Linh stood and walked over. Thanh An turned the chart toward her and pointed to a line with the tip of her pen.
“This is missing something.”
Tú Linh bent down to look.
“Yes?”
“You wrote that the patient was nauseated, but you didn't assess when the symptom began. Was it related to eating or taking medication?”
Tú Linh reread her own line, then fell silent.
“Uh...”
“Mm-hmm.”
Thanh An drew a small mark beside it.
“Do it again.”
“Yes.”
“However, this one is only acceptable for now.”
Thanh An paused before continuing. “Overall, your chart is fine. The rest is acceptable for now too. You just need to pay closer attention when taking the history of the main symptoms.”
“Thank you.”
“Mm.”
Tú Linh took her chart and returned to her seat. She didn't say anything, but she felt a little lighter inside. Thanh An had corrected her just like everyone else and hadn't let anything slide. It was simply the way she spoke that made Tú Linh feel she wasn't being judged too harshly. Thanh An looked over the five charts in front of her one more time, then stacked them together.
The group thought they were finished, but she didn't hand the charts back right away. She leaned against her chair and rubbed her temples.
“You have to stay completely focused when you're studying... But the way you all study...”
Her voice remained calm, and all five of them looked up to see what was coming. Thanh An looked at each of them in turn, then let out a quiet sigh.
“Once you're out in the world, don't tell anyone you're my students.”
The room went dead silent. Quân lowered his head, and Khánh pressed his lips together. Mai and Trang exchanged a look, then immediately turned away. Tú Linh lowered her head too, trying to keep a serious expression.
Thanh An continued in the same even tone, as if she were commenting on something perfectly ordinary:
“You're making me look so bad I could die.”
This time, even Khánh didn't dare laugh. Thanh An wasn't trying to humiliate anyone. She was simply looking at the five young faces before her with an expression that was equal parts helpless and serious.
“I don't expect you to produce a perfect chart on your first try. You're only just starting your internship, and making mistakes is normal. But when you make a mistake, you need to know where you went wrong. If you don't know, ask. If you haven't checked, check again. Don't fill in things you're unsure about just because you're afraid your chart will look incomplete.”
She tapped the tip of her pen lightly against the desk.
“Once you start working, there's a real patient behind every line you write. One incorrect number, one overlooked symptom, one piece of information recorded inaccurately... any of those can cause someone to misjudge the patient's condition.”
No one spoke. Thanh An looked at each of them.
“You may not be good yet. I can accept that. But you have to learn how to do your work properly.”
The words were gentle, but the entire group fell silent.
“All right.” Thanh An pushed the charts toward them. “Take them downstairs and fix them.”
“Yes.”
The five answered in unison.
They had just stood up when Thanh An added, “And next time, before you show me your work, read it over at least once yourselves.”
The group nodded slightly.
“Yes.”
“Don't make me be the one to find basic mistakes that you could have caught just by rereading your own work.”
“Yes.”
“Go.”
The group gathered their charts and left the room. Tú Linh was the last to go. Before stepping through the door, she turned back without thinking. Thanh An had already lowered her head and continued reviewing another patient's file. Morning sunlight streamed through the glass window and fell across one corner of the desk. She remained as composed as ever, as if five students hadn't just been put through the wringer by her.
Tú Linh pressed her lips together. For some reason, Thanh An's words kept circling through her mind. Once you're out in the world, don't tell anyone you're my students. It sounded like a reprimand. But Tú Linh knew that if Thanh An truly didn't care, she wouldn't have spent so long reading every single line of all five charts.
She wasn't strict because she wanted to make things difficult for them. She was strict because she genuinely wanted to make sure that when the five of them eventually walked out through the doors of this hospital, none of them would have to bow their heads in shame over having worked carelessly.
Tú Linh hugged the chart to her chest and hurried to catch up with her friends. Their internship was still a long way from over. And this was only the first day of the many lessons Thanh An would teach them.
The group had barely left the room when the door clicked shut behind them, and the hallway returned to its usual quiet. They had taken only a few steps when a woman approached from the opposite direction. She wore a white coat, her long hair neatly tied back at the nape of her neck. She had delicate features, but her eyes held the sharpness of someone far too familiar with hospitals. The moment they saw her, the entire group stopped.
“Hello, Doctor.”
“Hello, Doctor.”
“Hello, Doctor.”
All five greeted her and bowed. The woman looked slightly surprised, then smiled and nodded. Their eyes passed over her before stopping at the name badge on her chest.
Đỗ Thu Huyền – Cardiology Department.
“Hey, you guys.”
She smiled at them, then walked straight into Thanh An's office as if she were completely at home there.
The door opened. Thanh An was sitting behind her desk, her cool expression from the chart review still firmly in place. She looked up at the person who had entered, then lowered her head back to the stack of charts.
Đỗ Thu Huyền didn't pay any attention. She pulled out a chair, sat down, and casually picked up the teapot on the desk to pour herself a cup.
Thu Huyền took a sip, set the cup down, and studied her friend's face for a few seconds before laughing.
“Oh my God.”
Thanh An looked up.
“What?”
“Look at that grumpy face.”
Thu Huyền propped her chin on her hand, trying not to laugh.
“You just finished lecturing the kids?”
Thanh An was silent for two seconds.
“Yeah.”
“Called it.”
Thu Huyền burst out laughing.
“All these years and you still haven't changed. Every time you're annoyed, you look like someone stole your rice book. It kills me.”
Thanh An didn't argue. She simply turned to another page in the chart.
“What brings you here?”
“I missed you, so I came to visit my little sister from another mister. Can't I?”
“Get to the point. I'm about to go to a meeting.”
Thu Huyền immediately became more serious. She placed a file on the desk.
“I have a cardiology case and wanted your opinion.”
“What does the heart have to do with me?”
“If it didn't have anything to do with you, why would I come here?”
Thanh An took the file and quickly flipped through a few pages. Her expression changed almost immediately. The laziness from moments ago disappeared, replaced by the familiar focus of a doctor facing a problem that needed solving. The two began discussing the patient. One asked questions, and the other analyzed.
Every so often, Thanh An would pause for a few seconds, point to a test result, and offer a few concise comments. Thu Huyền listened intently, occasionally nodding and occasionally asking another question.
The discussion continued for a while. When Thu Huyền finally closed the file, she suddenly remembered something else.
“Oh, right.”
Thanh An looked up.
“Yes?”
“Those kids from earlier...”
Thu Huyền smiled.
“I ran into them the other day.”
Thanh An raised an eyebrow.
“Huh?”
“Over in my department.”
She leaned back in her chair.
“It was almost the end of my shift. The kids looked like they were getting ready to leave, but they saw a patient who needed help getting down to Cardiology, so they stayed behind to help. They didn't leave until everything was taken care of.”
Thanh An said nothing, and Thu Huyền smiled softly.
“They were really cute then. A little clumsy, but hardworking. The moment they saw a patient needed help, they ran right over.”
She rested her hands on the desk.
“It'd be great if the next generation of doctors all turned out like that.”
Thanh An nodded faintly.
“Yeah.”
“You're doing a pretty good job teaching them.”
Thanh An immediately looked at her.
“They haven't amounted to anything yet, and you're already complimenting me? Isn't that a little premature?”
“I just say what I see.”
Thu Huyền laughed.
“It just sucks for the kids that they ended up with the hospital's number-one toughest vice department chief.”
Thanh An replied calmly, “If I weren't strict, they'd go out into the world and hurt someone, then say they were my students. I'd be furious.”
“Oh, wow.”
Thu Huyền laughed so hard she had to set down her teacup.
“There you go, admitting you're strict yourself.”
Thanh An paid no attention. She lowered her head and returned to the file. Thu Huyền watched her for a moment, then asked, “So, are you planning to keep those kids in Oncology?”
Thanh An's hand paused.
“That depends.”
“Oh?”
She looked up, her expression so calm that the next words sounded even colder.
Thu Huyền froze for a few seconds, then burst out laughing.
But before standing up, she didn't forget to add one last jab:
“These kids look like they have potential. Do your best teaching them, Dr. An. Don't make them run themselves ragged.”
Thanh An didn't look up.
“Thanks.”
“Hey, if you don't want them, send them to me. I'm already fond of these kids—especially the fat one. Kkkkk.”
The door closed behind Thu Huyền. Outside, the five students were still waiting for one another at the end of the hall, completely unaware that a doctor from Cardiology had just praised them in secret. Inside the room, Thanh An continued looking at the file in front of her for a few seconds.
Then, not knowing what she was thinking, she let out a quiet breath.
“Such little busybodies...”
Her voice was barely audible. But the corners of her lips curved faintly because no matter how much of a headache those kids gave her... they were still her students.