In a hospital room, a patient in bed number five, Qian Xiong, was on the phone with his wife, his tone not very polite.
"Didn’t I tell you not to bother Ah Long with sothing this minor? I said it would’ve been fine to just get it checked out at the county hospital. It’s just appendicitis, yet you had to make co to City First Hospital. And fine, we ca to City First Hospital, but why did you have to tell Ah Long?"
"The doctors in the ER are very responsible. They’ve already run several tests on . You really didn’t need to tell Ah Long. Now we’re just bothering him."
Qian Xiong was in his fifties, a worker who delivered barrels of drinking water. He had always been a proud and stubborn man who hated bothering his relatives.
He had only co to City First Hospital because he couldn’t talk his wife out of it. He had wanted to just get so anti-inflammatory treatnt and let it heal on its own, with no intention of going under the knife.
He didn’t think much of a minor ailnt like appendicitis.
As Qian Xiong was on the phone with his wife, he saw Jiang Ming walk in, followed by Song Qi, Yasui, and a young doctor.
Qian Xiong frowned at the sight of this procession and grumbled into the phone, "I told you not to notify Ah Long. Great. Now you’ve made sure all our relatives know I’m hospitalized at City First Hospital."
"And Ah Long... I just have a minor case of appendicitis, and he has to arrange for so many doctors to co examine ."
"Okay, that’s enough. The doctors from City First Hospital are here in force now. I hope you’re happy. I’m hanging up!"
With mixed feelings, Qian Xiong hung up. He wasn’t the least bit surprised by the arrival of Jiang Ming and the others.
Only after Jiang Ming’s group drew near did Qian Xiong put on a pleasant expression and say:
"Director Jiang, it’s just a minor case of appendicitis. There’s no need to trouble so many of you. Since Dr. Song said conservative treatnt isn’t an option for right now, I’ll agree to the surgery. But I don’t want a laparoscopic appendectomy. I heard that one’s expensive, and my insurance doesn’t even cover it."
Qian Xiong had been frugal his entire life; otherwise, he wouldn’t have insisted on conservative treatnt earlier. "Director Jiang, just schedule for a traditional appendectomy."
As a deputy chief physician, Jiang Ming was very experienced in communicating with patients. He had a commanding presence and didn’t answer Qian Xiong directly. Instead, he chatted about the illness for a mont, asked about the patient’s recent condition, and only then did he begin to explain calmly:
"Uncle Qian, there’s no need to rush. Before any surgery, we’d like to perform a comprehensive examination and review your dical history to formulate a more thorough treatnt plan."
"So, let’s start by taking a comprehensive dical history and conducting a more detailed and objective physical examination."
Jiang Ming was following Wu Ting’s suggestion.
Qian Xiong considered Jiang Ming’s words for a mont. He naturally assud this was an arrangent made by his cousin, Tang Long, to get him a more detailed examination and a more comprehensive and precise treatnt plan.
He couldn’t very well refuse such a kind gesture from Tang Long.
"Alright, then. I’ll have to trouble you, doctors."
Qian Xiong fully cooperated with Director Jiang’s examination.
Standing to one side, Wu Ting paid close attention to Jiang Ming’s physical examination and the questions he asked to gather the patient’s dical history.
As the thorough examination progressed, Wu Ting noticed sothing strange: an unusual skin infection on Qian Xiong’s lower right abdon.
Furthermore, there was so functional impairnt on the dorsum of his right big toe.
Additionally, Wu Ting noted that when Jiang Ming pressed on the right side of the patient’s spine, the patient experienced radiating pain.
Then, as Jiang Ming continued the physical exam, Wu Ting also carefully noted that the patient felt pain in his lower abdon, groin area, and the front of his thigh.
Aided by Professor Shen Guofeng’s Diagnosis Skill (Purple), a different idea began to take shape in Wu Ting’s mind.
’If my guess is right, then the entire diagnosis is heading in a completely different direction from Jiang Ming, Song Qi, and Yasui.’
’No doubt, Jiang Ming and the other two were thinking it was so form of acute abdon. They might even be starting to consider rare diseases. According to their line of thinking, they’d definitely want to perform an abdominal paracentesis. They would make a definitive diagnosis and treatnt plan based on the nature, color, clarity, and odor of the abdominal fluid, as well as the lab results.’
’If that failed, the only remaining option would be to confirm the diagnosis intraoperatively by opening the abdon during the appendectomy.’
Wu Ting, however, now wanted to invite physicians from the orthopedics departnt and the National dical Departnt for a joint consultation to confirm a diagnosis and establish a treatnt plan.
After Jiang Ming completed his detailed physical exam, Wu Ting had a preliminary diagnosis. However, he still needed the expertise of the orthopedics and National dical departnts to reach a final conclusion and formulate a treatnt plan.
After a mont of thought, Wu Ting decided to gather a little more information for the dical history. Picking up where Director Jiang had left off, he asked a seemingly casual question:
"Uncle Qian, could I ask what you do for work? Or if you’ve done heavy physical labor in the past?"
Hearing Wu Ting’s seemingly random question, Jiang Ming, though not quite understanding, didn’t stop him. Instead, he stepped aside to make room for the younger doctor.
Song Qi, however, thought Wu Ting was just grandstanding, trying to show off. ’Director Jiang already did such a detailed examination, and he still has to ask such a basic question? What’s he trying to prove?’
’Besides, with Director Jiang and an attending physician like myself right here, it’s a bit presumptuous for a junior doctor like him to speak up.’
Song Qi was not as magnanimous as Qin Donglai. Of course, his reaction was understandable; most junior doctors wouldn’t dare to step forward at a ti like this.
Song Qi looked at Wu Ting and shook his head. ’Using physical labor and a patient’s job to diagnose a type of acute abdon? How could I have never heard of such a miraculous diagnostic thod?’
Song Qi still felt the proper course of action was to proceed with the general diagnosis of an acute abdon and perform an abdominal paracentesis without delay.
’Modern diagnostics aren’t like the mystical mumblings of old-school National dicine, where a few questions could supposedly yield a diagnosis. Everything today relies on precise test reports. The data is what it is—exact and reliable.’
Wu Ting, however, paid no mind to Song Qi’s reaction. The patient’s answer was critical.
Qian Xiong knew the doctors ant well, and after such a thorough examination, he was of course ready to tell them everything.
"Dr. Wu, you’ve got a sharp eye. I work at a drinking water station in our town. I’ve been delivering water barrels for decades. In so of the buildings that don’t have elevators, I have to haul them up the stairs step-by-step."
As he spoke, Qian Xiong rubbed his weary arms and legs and stretched his back.
Wu Ting’s eyes lit up. He stepped forward again and pressed on the patient’s lumbar spine and then his right foot.
Qian Xiong grimaced and yelped, "OW! Dr. Wu, easy, easy! That hurts!"
Wu Ting was now about eighty percent certain.
’A long history of climbing stairs while carrying heavy loads, weakened dorsiflexor strength in the right big toe, radiating pain on the right side of the spine...’
Watching Wu Ting put on this show, Song Qi asked with pointed sarcasm:
"Well, Dr. Wu? Have you co up with so brilliant idea?"
Wu Ting turned his head and replied with calm composure, neither servile nor overbearing:
"I do have a few thoughts, actually. I’m not sure what conclusions Director Jiang, Dr. Song, and Dr. An have reached. If you’re all about done here, shall we head back to the office to discuss this further?"
Seeing Wu Ting act this way, Jiang Ming grew curious as well.
"Alright. I’m just about finished with my examination. Dr. Song, Dr. An, how about you?"
Not that Song Qi and Yasui had any further insights, but they couldn’t let themselves be upstaged by Wu Ting at a ti like this.
"Yes, we’re finished as well. Let’s go back and discuss it. We can also hear Dr. Wu’s expert opinion."
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