"Teacher Liu, this is the freshly developed radiograph," Miao Rui rushed over with the films.
"Tell what you saw," Liu Banxia said.
Miao Rui slipped the film into the viewer. "There's mild inflammation, just as you inferred. This minor inflammation shouldn't be the primary cause of the patient's rapid weight loss."
"Brother Wang, should we start with antibiotics?" Liu Banxia then looked at Wang Huan.
Wang Huan, who was also focused on the film, nodded. "Let's try that first. However, the true cause still needs to be figured out. The pneumonia isn't very severe, so how could he lose weight so quickly?"
"If the patient is doing okay after the IV, we should do another stool test. Let's do one more tomorrow morning to check for parasites."
"If it isn't parasites, it could be an immune system disorder. After all, his current test results have already ruled out many causes of rapid weight loss."
"Exactly. There are only a few common causes for rapid weight loss," Liu Banxia said.
"The most likely are digestive system diseases, such as enteritis or gastritis. However, those would typically present with abdominal pain or similar symptoms, which the patient hasn't shown."
"Other possibilities include diabetes, pulmonary tuberculosis, intestinal tuberculosis, and hyperthyroidism. We can also schedule a colonoscopy for tomorrow morning to check for intestinal tuberculosis."
"Malnutrition or anorexia nervosa are other potential causes, but the patient claims his diet is fine. If there were issues, they would have been detected by now."
"The last three possibilities are parasites, tumors, and immune system diseases. For now, we can only continue to rule things out one by one. Anyway, based on the current results, the pneumonia can't be the correlating symptom for this condition, right? What do you all think?"
"Teacher Liu, could the patient be experiencing so sort of withdrawal?" Xu Yino asked.
Liu Banxia thought for a mont then shook his head. "If it were withdrawal symptoms, there would be signs like a runny nose, incontinence, and agitation."
"The patient has been emotionally stable both during his admission and currently. The only anxiety he's shown is concern for his own health. So, we need to help him by diagnosing his condition."
"How about this: tomorrow, let's also order a thyroid function test for the patient. What if it's a specific manifestation of so hyperthyroid condition?" Wang Huan suggested.
"Alright, that's settled. Miao Rui, did you get all that?" Liu Banxia asked.
"Got it. I'll go inform the patient now," Miao Rui replied, nodding.
"Wait, consult with him first. It would be best if he contacts his school counselor or family," Liu Banxia said.
"Although he seems well-dressed and his family appears to be well-off, we don't know his actual situation. It's best to have a family mber present."
"Teacher Liu, I did talk to him about it. But he said his dad is probably herding livestock on the grasslands and might not be able to get away," Miao Rui explained.
"Try to discuss it with him further. Kids these days often think they're mature enough to handle everything, but that's not always true," Liu Banxia said.
Miao Rui nodded and headed towards the ward.
Actually, Liu Banxia could guess why the patient hadn't called his family over after all this ti. On one hand, he was probably worried his parents would neglect things at ho out of concern for him. On the other hand, he suspected he might have contracted so kind of "unclean" disease. Even though they hadn't seen his girlfriend yet, it was a strong possibility. He himself hadn't had the 'ans' back in the day; otherwise, he might have fooled around a bit too.
"It's an old question," Liu Banxia mused, "but besides continuing the stool tests and doing the colonoscopy tomorrow to check for lymphoma, what else can we do?"
"What if we also order an ultrasound? We should pay close attention to the pancreas," Wang Huan suggested.
Liu Banxia thought for a mont and nodded. "Even without accompanying pain or jaundice, it's worth checking. Right now, we're pretty much guessing blindly, trying to eliminate all plausible causes one by one."
This was a simple consultation. Even though it was just a brief exchange between the two of them, they had generally narrowed down the possible causes of the illness.
"We've certainly diagnosed a high number of unusual cases here recently," Wang Huan remarked.
"Haha, maybe my fa is growing. This patient also ca because they heard of ," Liu Banxia said with a laugh.
"But it's not just because of that. It's also because, many tis, we might have let potential cases slip through."
"How many tis has that happened here? All because we paid a little extra attention. Never mind cases from long ago; look at this recent one. If the patient hadn't insisted and Brother Wei hadn't paid a bit more attention, that patient would have been discharged."
"And this patient, if it turns out to be dullary cavity expansion, will definitely suffer frequent fractures later on. By then, who knows if other hospitals will take it seriously. I doubt she'll be able to co back to our Second Hospital."
"Often, we do consider a patient's past dical history, but we still rely primarily on our own examinations. This can sotis lead us to overlook the progression of the patient's condition, affecting the diagnosis."
"It's unavoidable. After all, we often have to rely on educated guesses. Take this student, for example. If he had co to our hospital when his symptoms first appeared, even if we hadn't diagnosed him back then, we'd at least have a clearer picture of his condition now."
This is a common problem in society. Hospitals are spread out, and patients don't necessarily beco 'loyal fans' of one particular hospital, rushing there at the first sign of discomfort. Moreover, even if they do, the attending doctor might not be the sa one each ti. And even if it is the sa doctor, they see so many patients they might not rember a specific case. The only advantage is being able to review past dical records, which offers so help. Actually, sotis it's not about trying to make more money by not accepting test results from other hospitals. It's because illnesses develop and change, so a diagnosis must be based on the latest results.
After a while, Miao Rui returned. "Teacher Liu, I've spoken with the patient. He'll call his family soon, and they should be here by tomorrow."
"What about his school? Will anyone co?" Liu Banxia frowned.
Miao Rui shook his head. "I suggested he ask a classmate to co and stay with him, but he ignored . I've already told Sister Li to have the nurses keep a closer eye on him tonight."
"Sigh... sothing must have changed in his school life. Even if he doesn't have classmates to call, he could at least ask his academic advisor to co and help us understand the situation," Liu Banxia said with a sigh of resignation.
He had already suspected sothing like this, and now it was further confird. Normally, no one's social life in college would be so bad that not even a roommate or classmate would visit. This young man was being very stubborn, only agreeing to call his parents after the hospital insisted. There was definitely sothing more to this situation.
However, he's an adult and has his own rights. The hospital can only offer advice; whether he accepts it is his decision.
"Teacher Liu, could this be campus bullying?" Xu Yino asked curiously.
"Don't be silly. You can't just attribute everything to that. We need to analyze the specific situation. Don't jump to conclusions without knowing all the facts," Liu Banxia said with a smile.
"You all keep an eye on him; I have paperwork to do. If nothing major happens, I'll relieve you at three tomorrow afternoon so you can get so proper sleep."
"Teacher Liu, be generous. Can we sleep for half the night?" Li Hao asked earnestly.
"Sure, why not?" Liu Banxia replied. "Currently, not many patients co in during the second half of the night, and they usually have minor issues. If a serious case cos in, you wouldn't be able to sleep even if you wanted to."
The interns exchanged helpless glances. That was true. So, sleeping for half the night was essentially the sa as not sleeping much at all.
Regarding this patient's situation, Liu Banxia decided not to guess blindly anymore. It was better to rely on the actual test results. It was fine to think broadly and outline a general direction, but overthinking was unnecessary.
Besides, he also had to consider his teaching duties and the upcoming interview. Even if the interview was a comprehensive introduction to the ergency center, he would surely feature prominently and needed to prepare.
Just as Liu Banxia was about to fall asleep, Miao Rui ca to find him again. "Teacher Liu, the patient just started coughing lightly. At first, I thought his throat was just dry."
Liu Banxia nodded. "Continue to observe. It's likely caused by the lung inflammation. If the cough doesn't improve by tomorrow morning, order another chest CT."
"Okay. I just took his temperature; it hasn't changed," Miao Rui said.
"This patient's case is sowhat complicated," Liu Banxia said after a mont of thought. "You need to start thinking less like an intern and more from an attending physician's perspective now."
"Once you beco residents, we'll give you maximum autonomy. Unless you request a consultation, we generally won't interfere."
"If we threw you into that kind of life directly, it would be a mix of pain and joy, and then you'd feel stifled. So, it's good to get a taste of it now, so you can transition smoothly when the ti cos."
Miao Rui grimaced slightly and nodded.
Others might think this was a good thing, but having been here for so long, they knew Liu Banxia wasn't exaggerating.
They wanted to perform well, but they also had to bear the responsibility that ca with it. Responsibility in the ergency center was especially crucial and couldn't be handled carelessly.
What kind of people were the attending physicians and the "Big Demon King" in the ergency center? Trying to fool them was out of the question.
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