"Teacher Liu, why aren’t you wearing a shirt today? You’re back to T-shirts again; it doesn’t look good," Xu Yino voiced her opinion the next morning when she saw Liu Banxia dressed as usual.
"Sigh... Making money isn’t easy. A shirt costs several hundred yuan. How many tis can it be washed? It’s better to save it and wear it sparingly. This T-shirt of mine wasn’t cheap either; it cost a hundred yuan when I bought it," Liu Banxia said.
Hearing his words, Liang Xiaolin and Qing Kewa, who were beside him, couldn’t stop laughing.
"Doctor Liang, Qing Kewa, did sothing fun happen yesterday? I really regret not going with you guys," Liu Yiqing asked curiously.
"It’s a good thing you didn’t go, or you would have laughed yourselves silly," Liang Xiaolin said with a smile. "You should have seen him during his yoga lessons with Yanzi; his movents were so clumsy! He tried several tis, and eventually, even the people in Yanzi’s livestream chat said he should just give up."
"Is that my fault? What could I do? I really couldn’t stand contorting my body into so many poses," Liu Banxia said, still feeling a bit of lingering fear.
In his mind, playing the doting boyfriend was a daunting task, but helping Wang Xiaoyan with her livestream was a piece of cake.
Who would have thought it would be the complete opposite! Yoga looked graceful when others did it, but he just couldn’t get the hang of it. The livestream was very effective though; it looked quite joyful.
"President Liu, good morning," Wang Chao said as he approached, offering a formal greeting.
"I just took a look; there are only three patients left upstairs. It seems our ergency departnt is rather quiet these days. Later, I’ll arrange compensatory leave for you and Brother Wei, alright?" Liu Banxia said.
"Whatever you say. Are you busy right now? If not, I have sothing to discuss with you," Wang Chao said mysteriously.
"What new information do you have this ti?" Liu Banxia asked after they moved to one side.
"Hehe, the Chief Director has made a move. Old Qin’s move to the Dazheng Group is going to have so changes," Wang Chao said, looking quite pleased.
"Really? Does Chief Director Chen have that much power? And are you sure Qin Hai was behind that last incident?" Liu Banxia asked in surprise.
Wang Chao nodded. "This matter is like trying to wrap fire in paper; can it really be contained? The Chief Director talked to so many people. If each person leaks a little, the whole story can be pieced together.
"The Dazheng Group does such big business; are they fools? Regardless of whether this matter is related to the Dazheng Group or not, the Chief Director is furious, so they’ll have to weigh their options carefully.
"Originally, the Dazheng Group intended to hire Old Qin as the director of their health examination center, but now it seems soone else has been appointed. Although they will still hire him, it certainly won’t be as good a position as before.
"Actually, if you ask , they went a bit too far this ti. According to my analysis, Old Qin went over there intending to make so contributions to the Dazheng Group. But who would have thought that by doing this, it would cause such public outrage.
"Perhaps the Dazheng Group didn’t expect Comrade Qin to be so zealous. They probably thought poaching three or five doctors would be trivial and wouldn’t affect future cooperation between the two sides."
"You’re incredible, kid, to be able to dig up this kind of news," Liu Banxia remarked with admiration.
"Well, you listen around and analyze. Old Qin couldn’t see the situation clearly and made a bad call. What can be done?" Wang Chao shrugged.
Liu Banxia nodded. If Wang Chao’s information was accurate, then one could only say that Qin Hai had been bewitched and then used as cannon fodder by the Dazheng Group.
If he had poached three or five doctors quietly, for a hospital this large, it really wouldn’t have made waves. But he just had to stir up conflict, specifically to cause trouble for Chen Zhenxing and make him lose face, and in doing so, he poked the hornet’s nest.
"Teacher Liu, there’s a patient here with abdominal pain, and Teacher Wang still has patients in his consultation room," Su Wenhao, the triage doctor on duty today, ran over and said.
"Bring him to an examination bed. I’ll take a look," Liu Banxia nodded.
Although chatting with Wang Chao was quite pleasant, a patient with abdominal pain couldn’t be delayed.
The patient was a man in his thirties. When Liu Banxia saw him, he was bent over, clutching his abdon, and groaning in pain.
"When did the pain start? Any other symptoms?" Liu Banxia asked.
"It started last night. I thought it was just an upset stomach, so I took so dication for enteritis. This morning, it’s even worse," the patient said.
"Is it a cramping pain or a dull ache?" Liu Banxia asked further.
"My abdon hurts," the patient said.
"Hmm... Let examine you first. Xu Yino, take his blood pressure and temperature," Liu Banxia said.
The patient’s previous non-answer could only confirm one thing: he was in too much pain to concentrate.
First, he checked the patient’s McBurney’s point; there was no rebound tenderness. Then, he checked the patient’s gallbladder area, but the patient still showed no reaction.
At the very least, appendicitis and cholecystitis could be ruled out. As for ontitis, that condition is genuinely rare.
"Blood pressure 90/120, temperature 37.5 degrees Celsius," Xu Yino reported.
"Have you been to the toilet since last night? Eaten anything unusual in the past two days? Have you had diarrhea?" Liu Banxia continued to ask the patient.
The patient nodded. "I just ate normally. I had diarrhea twice, but that was during the first half of the night. After taking the dication for enteritis, I haven’t had any more. I didn’t eat breakfast this morning either."
"Alright, abdominal pain can have many causes. The physical exam and auscultation just now didn’t reveal any major problems. However, we still need to do a complete blood count and a stool test, and then we’ll arrange an ultrasound for you," Liu Banxia said.
"Currently, we can’t determine if the pain is due to simple enteritis or if there’s a lesion in an organ. Logically speaking, simple diarrhea wouldn’t be this painful."
The patient nodded. "Okay, as long as it stops the pain. This is killing ."
"Don’t worry. Now that you’re at our hospital, we’ll definitely find a way to relieve your pain," Liu Banxia reassured him.
"Teacher Liu, what condition do you think it is?" Xu Yino asked after the patient had left for sample collection and the ultrasound.
"How would I know? I’m not a psychic. Let’s wait for the test results. When the indications aren’t clear, we have to rely on the results. What’s with those disappointed expressions?" Liu Banxia said with a wry smile.
"Teacher Liu, you’re so skilled, we thought you could make a diagnosis right away," Xu Yino said.
"Well, we’ve made a partial diagnosis, haven’t we? We’ve ruled out appendicitis and cholecystitis," Liu Banxia shrugged.
"Teacher Liu, then why didn’t you do an ultrasound examination directly?" Huang Bo asked.
"Hmm... well, that’s a point. Although we have portable ultrasound machines, they are generally used only in ergency situations," Liu Banxia said.
"After the physical exam, we ruled out appendicitis and cholecystitis. The abdon is soft, which also rules out peritonitis. So, the next step is to have a specialized ultrasound physician conduct the examination.
"So, the question is: if the ultrasound examination and stool test still don’t yield any conclusions that can help with the diagnosis, what examination should be done next?"
"X-ray."
"CT."
Xu Yino and Miao Rui said in unison.
"Both are options, but we need to consider the waiting list. Even though our ergency departnt has so priority, we can’t abuse it. Doing so would cause resentnt among other patients and lead to conflicts," Liu Banxia said.
"When there are no clear indications, we’re essentially working through a multiple-choice problem. We have to use the process of elimination, ruling out possibilities step by step."
This sounded a bit like copping out, but Xu Yino and the others listened very attentively. This was a very realistic issue; many conditions could only be diagnosed this way.
After a bit of idle chat, the test results ca out. The complete blood count showed a slightly elevated white blood cell count, but the stool test and ultrasound were normal.
"Doctor, now it’s not just my abdon that hurts; my chest hurts too, and my whole body feels a bit sore," the patient said.
Liu Banxia frowned and examined the patient carefully again. The findings were the sa as before; the difference was that the patient’s symptoms had worsened.
He glanced towards the internal dicine consultation room; Wang Huan still had a patient, so he couldn’t call him over for a consult.
"Let’s run a liver function test as well; it might be hepatitis. After the blood draw, get a combined chest and abdominal CT scan too, to rule out intestinal perforation," Liu Banxia said after so thought.
The patient was in extre distress but was very cooperative. As soon as Liu Banxia finished speaking, the patient nodded. His attitude was clear: do whatever tests you need, just make the pain stop.
This ti, Liu Banxia arranged for it to be expedited. However, because CT scans inherently take a long ti, the wait was quite agonizing.
And these test results made Liu Banxia even more concerned. Liver function was normal, the CT scan was normal; after so many tests, there were still no clear diagnostic indicators.
Moreover, the patient now presented with new symptoms: mild edema, primarily on the eyelids and face.
Liu Banxia didn’t dare to wait any longer. He went directly to the internal dicine consultation room to get Wang Huan.
After reviewing the test results, Wang Huan also felt a headache coming on. "Have you had any other symptoms in the last few days? Try to think back. Do you have any history of heart disease?"
"Nothing much. I’ve been quite normal. Hmm... occasionally, if I drink sothing cold, I get diarrhea, but since the weather is hot, that doesn’t happen consistently, and it usually resolves after once or twice. I don’t have any history of heart disease," the patient said after thinking for a mont.
"Dr. Liu, I rechecked his temperature just now; it’s gone up to 38.4 degrees Celsius," Xu Yino said with so concern.
"Doctor, I don’t have a terminal illness, do I? Should we do an MRI?" the patient asked.
"Not so fast. We need to have a general direction before we can order the right tests for you," Liu Banxia said.
"It’s unlikely to be food poisoning. If it were, it wouldn’t develop this slowly, and there should be diarrheal symptoms by now."
He was genuinely troubled now. He hadn’t expected to hit such a roadblock on his first day back after a day off. Further tests were definitely needed, but he couldn’t order them blindly; that would not only waste ti but also be ineffective.
Even if he couldn’t pinpoint a definitive cause now, there should at least be a general direction. He had even considered intestinal tuberculosis, but that shouldn’t cause chest pain.
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