"President Liu, when will your craziness end?" Wang Chao asked during lunchti.
"Just a day or two more. What’s wrong? Can’t handle it anymore?" Liu Banxia asked with a smile.
Wang Chao nodded pitifully. "I didn’t feel it this acutely before, but now I think it’s a miracle I’ve held on this long. Thankfully, there haven’t been too many trauma patients—just four car accident victims, and none of them were severe."
"Don’t worry, things will wind down soon," Liu Banxia said comfortingly. "The situation in General Surgery has improved significantly, the pressure on the wards is lessening, and more doctors are performing their surgeries by the book."
"So, does that an there’s nothing wrong anymore?" Wang Chao asked curiously.
"It seems so. The Chief Director has spoken to them individually. I’m not entirely sure of the specifics; as you know, I’ve been glued to the operating room," Liu Banxia nodded.
Liu Banxia was indeed not entirely sure how the whole situation had unfolded. However, the utilization of the operating rooms had significantly increased, which had truly relieved the pressure.
There were many excuses to avoid surgery, likely a form of silent resistance. Surprisingly, the hospital didn’t indulge them; if they wouldn’t do the surgeries, that was that.
The outco seed to be a victory for the hospital, but the salary standards would also be adjusted appropriately.
He had learned all this from Wang Lei during breaks between surgeries. Compared to him, Wang Lei and his colleagues in the Anesthesiology Departnt had more to chat about.
Moreover, this incident wasn’t limited to just the doctors from General Surgery; it also involved people from other departnts. The commotion stirred up was significant, all because the allure from outside was too great.
It wasn’t that these people were acting improperly; everyone has the right to pursue higher salaries. However, so didn’t want to leave but still wanted to stir up trouble over it. That kind of behavior required so discussion.
"How many surgeries are scheduled for the afternoon?" Wang Chao asked.
"Two appendectomies and four laparoscopic cholecystectomies," Liu Banxia replied.
"If you’re itching to do one, I’ll let you have an appendectomy," Liu Banxia said. "I’ve done so many recently, I’m almost numb from it. I even get sleepy while doing them."
Wang Chao rolled his eyes. Showing off, that was just blatant showing off. However, there was nothing he could do; Liu Banxia’s achievents were apparent to everyone. He had been truly formidable these past ten days.
"Banxia, are you busy? I have a case to discuss with you." At this mont, Xu Hui ca towards them holding his food tray.
"Not busy," Liu Banxia hastily replied. "I only have minor surgeries this afternoon. I can handle it."
Internal dicine doctors like Xu Hui were also holding the fort in the ergency room, and they had really helped out a lot. Even if Liu Banxia truly wanted to lie down for a nap after lunch, he had to hear Xu Hui out.
"I admitted a patient a week ago," Xu Hui began. "Male, 42 years old, in good physical condition, with a two-week history of a dry cough. A chest X-ray showed slight inflammation in the lungs. His temperature was 38.3 degrees Celsius, and his CBC showed a slightly high white blood cell count. He was diagnosed with pneumonia."
"After four days of antibiotic treatnt, his condition didn’t improve, and new symptoms appeared: increased coughing, joint pain, fatigue, and listlessness."
"We observed him for two more days, and now he’s showing symptoms of edema in his lower limbs. Both his feet and calves have pitting edema. I’ve admitted him to the hospital now, so help think this through."
Liu Banxia frowned upon hearing Xu Hui’s account. "This isn’t just pneumonia. Pneumonia can’t cause edema in patients. Edema usually occurs only when there’s a problem with the internal organs."
"The patient has no history of hypertension, heart disease, or diabetes. His ECG is also normal," Xu Hui added.
"An ultrasound examination of his liver, gallbladder, pancreas, and spleen showed no abnormalities. However, new lab results show his albumin level is very low at 28 grams per liter, and his serum creatinine has reached 230 micromoles per liter."
"So, I suspect a kidney problem, and we’re currently waiting for the urinalysis results. But I’m also wondering if his kidney issue could be related to his pneumonia."
Liu Banxia nodded. "It’s hard to say. He’s in the ER ward, right? I’ll go check on him after lunch. Listening isn’t as accurate as direct observation."
"Teacher Xu, don’t we need to call soone from Nephrology to take a look?" Xu Yino asked curiously.
"We need to wait. We can only call them for a consultation after we have a clear diagnosis," Xu Hui replied with a smile.
"You guys should keep this in mind: there’s a physical distance between the ergency departnt and the other departnts now. So, if we need a consultation, we need to be as certain as possible about the indications."
"Can any of you imagine your esteed Teacher Liu getting yelled at for calling for consultations without being clear about the indications?"
Liang Xiaolin, who was nibbling on a bun, laughed, giving Liu Banxia a gleeful glance.
"Since I’ve already said this much, I might as well say a bit more," Xu Hui continued.
"Wow, Teacher Xu, are you going to spill more gossip about Teacher Liu? Aren’t you afraid he’ll silence you?" Liu Yiqing chid in.
"There isn’t that much gossip. You’ve probably pried everything you should and shouldn’t know out of Wang Chao by now, right?" Xu Hui laughed.
"What I an is, when giving a diagnosis, you can’t rely solely on descriptions. Unless the indications are very clear, only then can you make a corresponding diagnosis. If there’s any ambiguity, you must personally examine the patient, just like your Teacher Liu."
"Because descriptions from others will, more or less, always omit sothing. These omissions might lead to a certain degree of misdirection, resulting in a misdiagnosis that could possibly delay treatnt and even threaten life."
Xu Yino and the others were stunned. As doctors, they often received ssages or calls from relatives and friends asking for advice about minor ailnts.
Not responding didn’t feel right, so they often gave diagnoses and dication recomndations based on their knowledge. It seed they would really have to be more careful in the future. Being a doctor required caution, caution, and more caution.
With this on their minds, Liu Banxia and the others began eating faster. Then, under Xu Hui’s lead, they bustled into the patient’s room.
The patient lying on the bed receiving an IV infusion was shocked to see so many doctors enter. He was already very anxious when he was first admitted.
"Hello, this is our ergency departnt’s Chief Resident Physician, Liu Banxia. I invited him to consult on your case," Xu Hui said.
The patient’s wife, who was nibbling on so corn, stood up nervously when she heard Liu Banxia introduced with the title "Chief" and saw the crowd accompanying him.
Liu Banxia carefully observed the patient and conducted a simple examination. The patient’s symptoms were almost the sa as described by Xu Hui.
"You’re not locals of Binhai City, are you?" Liu Banxia asked.
The patient’s wife nodded. "We’re from Little Wang Village. We didn’t get any better at the county hospital, so that’s why we ca to a larger one. This illness is tornting us. At the county hospital, they couldn’t figure out what was wrong, and they couldn’t treat it effectively."
"We know that treatnt in large hospitals costs more, but as long as the illness can be cured, it’s all worth it. Otherwise, we would keep spending money without seeing any improvents."
"Did you have a CT scan and bronchoscopy?" Liu Banxia asked Xu Hui.
Xu Hui nodded. "We did both. Apart from what looks like pneumonia, nothing else was apparent."
This was a bit tricky. The patient was from out of town, which ant reimbursent would be an issue. Therefore, it was crucial to be prudent when deciding on dications and tests. His family probably wasn’t very wealthy, so they had to be cautious with treatnt choices. Especially since this illness might also involve his kidneys. If it progressed to kidney failure, this family would be ruined. It wasn’t uncommon for an illness to financially ruin a family; in fact, it was a very common situation. Even with dical insurance and cooperative dical services, the cost of treatnt could be substantial, with no clear upper limit.
"Ah, Dr. Liu, you’re back. These are the results of the urinalysis." At that mont, Xu Dan walked in.
Liu Banxia and Xu Hui looked at the results together: urine protein , occult blood . These findings confird their initial judgnt that there was a problem with the patient’s kidneys.
"Doctor, is it very serious?" asked the patient lying on the bed.
"At the mont, we can’t give you a specific diagnosis yet. Have you lost a considerable amount of weight recently?" Liu Banxia asked.
"How could I not lose weight? Seeing the money go and no improvent in sight, I can’t even eat," the patient said with a bitter smile.
"We planted so early corn in our backyard this year, but a late spring cold spell hit us, and the cobs were small and hard to sell. After selling the corn, we were planning to go out to find work and earn so money, but then I fell ill. This is fate, I suppose. It just won’t let us have a good life."
The patient’s tone was filled with helplessness. Although he didn’t bla Xu Hui for not having cured him yet, both Xu Hui and Liu Banxia felt their faces flush.
The patient’s condition was indeed complicated: high fever, pneumonia, edema, and possible kidney complications. Standard antibiotic treatnt hadn’t shown much effect so far.
Before calling Nephrology, they needed to connect the current symptoms.
The obvious progression was: first a cough, then pneumonia, followed by high fever and edema, and then the kidney problems.
At this point, Liu Banxia focused his attention on the corn cobs on the bedside table. They were all broken in half, and so had large knife marks where a significant chunk had been cut away.
"Doctor, if you like corn, please have so," the patient’s wife said. "My husband usually loves eating fresh waxy corn—boiled, grilled, or stir-fried, it’s all delicious. Even though the cobs are small, they’re good waxy corn."
"And you’ve been eating it often since you planted it at ho?" Liu Banxia asked with a smile.
The patient’s wife nodded.
"That’s pretty much it, then?" Liu Banxia said, putting down the corn cob.
Xu Hui nodded with a wry smile. "You’re most likely right. How did I not think of that?"
Their conversation left not only the patient and his wife but also the interns like Liang Xiaolin completely bewildered. Had they made a diagnosis just by looking at the corn? Wasn’t that a bit too far-fetched?
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