"Teacher Liu, sothing seems off. The patient's white blood cell count is very high, but there are no signs of inflammation on the chest X-ray," Li Hao said, approaching with a furrowed brow, holding the test report and chest X-ray.
Hearing this, Liu Banxia paused for a mont. "Let take a look."
After reading the report, Liu Banxia also frowned.
He still rembered this patient; he had even praised Li Hao for this case. His initial judgnt was also pneumonia; how could there be no signs?
"What do you think? What kind of examination should we perform next?" Liu Banxia asked after a while.
"A high white blood cell count indicates an infection or inflammation. If it's not in the lungs, it could possibly be in the abdominal cavity. If there's nothing wrong with the abdominal cavity, we should consider blood-related diseases," Li Hao replied.
"I recomnd we perform an abdominal ultrasound first. This initial examination can check for issues with the organs in the abdominal cavity. If no issues are found, we should consider tests for leukemia-related diseases."
Liu Banxia nodded. "Let's proceed in that direction. Find Xu Yino and have her perform another physical examination on the patient. If there's a lesion in the organs in the abdominal cavity, there should be signs of abdominal pain."
"Alright, I'm heading there now," Li Hao replied.
"Hold on," Liu Banxia added. "Before explaining the situation to the patient, be careful with your words. After all, there will be further instruntal examinations. Preferably, conduct no more than three before a clear indication erges."
"The chest X-ray has already been used once. So, if the ultrasound also yields no results, your recomndation for a third instruntal examination must be even more cautious."
"Understood. I'll be patient in explaining to the patient and their family," Li Hao nodded.
This was sothing he hadn't considered. Although he had ntioned the possibility of a blood disease, in his heart, he was more inclined to believe it was an intra-abdominal disease.
Now he rembered that during the consultation, the patient had never expressed any abdominal discomfort. And a lesion in an abdominal organ most commonly manifests as 'abdominal pain'.
This also indicated that the patient's abdominal organs might be fine. If he spoke too definitively when he went over, it could cause resentnt from the patient and their family.
This was an important lesson, even relating to a doctor's 'self-preservation.' When there's no data to support a claim, one cannot speak too definitively, nor should one confine their thinking.
Otherwise, if sothing genuinely went wrong and the patient found a loophole, it would lead to a complaint at best, or a dical lawsuit at worst.
Liu Banxia didn't dwell on this matter too much. In any case, everything depended on the examination results. The current high white blood cell count clearly indicated a problem.
"Teacher Liu, I see that all your surgeries scheduled for tomorrow have been moved to the afternoon," Su Wenhao ntioned, walking over.
"Moving them to the afternoon is safer. We don't know if today's patient will undergo surgery. If they consent to surgery, I'll have to assist," Liu Banxia said.
"How has it been these past two days on the operating table? Have you gotten your feel back? Our primary skill still needs to be displayed on the operating table."
Su Wenhao smiled and nodded. "Don't worry, Teacher Liu, we're fine. Actually, nine days isn't very long. But when I first got back on the table, my hands did feel a bit off."
"That's good. The key is still regular practice. Don't let your hands get too tired during usual training, to avoid injuring them," Liu Banxia said.
"How have things been recently? You didn't go ho for the Spring Festival; have you been in touch with your family since then? Can they understand your decision?"
"They can understand. Actually, I don't bla them for having such thoughts," Su Wenhao said candidly.
"Anyway, it's just one possible career choice. They haven't been to big cities and don't know how much higher the dical standards in big cities are compared to county-level ones."
"I also need to work hard and strive to master more dical knowledge. In the future, whether I stay here or go ho, I won't let it go to waste."
"In fact, I'm already very lucky to have gotten this far in my studies. Without my family's support, I would never have had the opportunity to study dicine."
"Indeed," Liu Banxia agreed with a nod. "Studying dicine has a very low return on investnt."
"It already takes longer to study than others. When others graduate, they might get a relatively good position in one or two years. But for dicine, graduation is really just the beginning."
"Take the current reality, for instance. Master's degrees are already very common, and the requirents for educational qualifications are getting higher and higher. Otherwise, not so many people would continue to pursue a doctorate after working for a few years."
"Since opportunities are hard-won, grasp them well. In our ergency center or the Second Hospital, there will be many opportunities to learn. Also, don't push yourself too hard; dicine requires gradual progress."
"Currently, our ergency center has enough surgeries, so you don't have to worry much about their scheduling. However, when the new interns and resident physicians arrive, appropriate adjustnts will also be needed."
"It's still what I said before: don't try to bite off more than you can chew. Choose a direction you like or are good at and slowly conquer it."
"We have such convenient conditions here, so we must utilize them. Never assu that your skills will improve just by participating in more surgeries."
"For you now, the most important thing is to identify your deficiencies and fill in the gaps. Use this ti to undergo intensive training in those areas."
"That's why I'm sending you over in batches. After it's over, you'll work in the departnt for a period before exchanging for training again. You also need to be given enough ti to digest and recover."
"Teacher Liu, will future internships also be conducted according to these standards?" Su Wenhao asked curiously.
Liu Banxia shook his head. "Of course, we can't set such high standards for everyone, but we will have phased assessnts. After an assessnt, we can get a general idea, and then we'll have to do batch-specific targeted training."
"That is, I will divide the trainees into levels and appropriately increase or decrease training courses and pressure based on a certain level."
"This kind of work will be very tiring and requires the cooperation of various departnts. I'm off the day after tomorrow. When I co back, I'll go talk to each departnt. This is my general idea."
"That kind of work would be very tiring, right? And it would require all departnts to cooperate," Su Wenhao said.
"Yes, it will definitely be tiring, but this is all I can think of for now. We have to make changes, but not too drastic," Liu Banxia said.
"I don't have a concrete concept right now, and ti is a bit tight. There will be a lot to do next. I can only say, comprehensive training with key highlights."
"Teacher Liu, Teacher Liu, we found it! It's suspected to be a hepatic cyst."
At this mont, Li Hao ran over again, holding the ultrasound report.
"Did you examine the patient? Is there mild jaundice?" Liu Banxia asked curiously.
Li Hao shook his head with a wry smile. "No. After the ultrasound, I carefully examined the patient again. This patient is truly strange: no abdominal pain, no jaundice, yet three liver abscesses."
"However, we can roughly determine they are liver abscesses. It wouldn't be liver cancer, right? Otherwise, there would definitely be physical signs, wouldn't there? The patient asked, but I didn't dare to say directly."
"So, what's next? What tests?" Liu Banxia continued.
"Blood biochemistry and liver CT," Li Hao replied.
"You're still a bit too timid," Liu Banxia said with a smile. "Go directly for a contrast-enhanced CT; that will allow a much clearer view. Although the cost is higher, it can provide very clear indications."
"Even a regular CT scan won't be much clearer than an ultrasound. With a contrast-enhanced CT, we can pretty much differentiate between a cyst and a tumor, and it will also save the patient from anxiety."
"If it's an ordinary cyst, perform another detailed examination tomorrow morning, and then do an aspiration drainage. You perform the procedure. If I don't have ti, have Wei Yuan or Shi Lei supervise."
"Thank you, Teacher Liu! I'll go explain the situation to the patient now," Li Hao responded happily and ran off in a flash.
He was really happy. Although it wasn't a sexually transmitted disease, it was, after all, a diagnosis he helped make through careful observation.
"Teacher Liu, if there's nothing much going on tomorrow morning, can I also observe?" Su Wenhao asked.
Liu Banxia nodded. "Of course, anyone who wants to go can go. But it also depends on the situation on-site tomorrow; otherwise, it could get chaotic."
This was another case resolved. From his overall performance, Li Hao did very well. Those so-called flaws weren't really flaws.
When this patient's contrast-enhanced CT results ca out, it was confird as a hepatic cyst. There were no further problems; after an examination the next day, drainage could be perford directly.
For the mother and daughter, they had just experienced quite a scare. Liver cancer and a hepatic cyst are two completely different concepts.
Around nine o'clock in the evening, just as Liu Banxia was pondering whether to take a nap first, the daughter of the patient with the pseudoaneurysm ca to find him.
The family had agreed; they still wanted to go ahead with the surgery and take the chance.
"Alright, I'll call Dr. Chen and ask," Liu Banxia nodded and dialed the number.
"An ergency surgery?" Chen Xuehai's voice ca through.
"No, it's the patient with the pseudoaneurysm. They've agreed to the surgery. When should it be scheduled? I'll book the operating room," Liu Banxia quickly said.
"Tomorrow morning," Chen Xuehai said. "I'll formulate a surgical plan in a bit, then we'll discuss it. You'll need to join on the table tomorrow."
"Alright. How late will you let sleep tonight?" Liu Banxia asked pitifully.
"Depends on your comprehension," Chen Xuehai said and hung up.
Liu Banxia shook his head helplessly. Looks like there'll be no peace tonight.
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