Free Web NovelChapter 558: Chapter 256: Treating Deafness, Punk Kid Meets Violent Mom
"Last night, her child sneezed and started bleeding again. They rushed to my clinic in the middle of the night. After examination, I found purple bruises on the child’s hands and feet. Upon checking the child’s mouth, there were blood blisters under the tongue and on the oral mucosa. I believe the likelihood of acute ITP is high. Since the child is only 5 years old, the possibility of congenital T-cell deficiency is low. Ultimately, my initial diagnosis is acute ITP caused by a viral infection."
Li Jingsheng detailed his diagnostic reasoning.
This type of complex case was completely out of Dr. Wang’s depth.
Only Dr. Shao could somewhat participate.
Internal medicine, in fact, really tests clinical experience, clinical diagnostic thinking, basic medical knowledge, and case knowledge.
Only doctors with the above four strengths can become excellent internists.
To become a top-rated internist, one needs to have a high level of pharmaceutical knowledge, as well as courage, meticulousness, careful thinking, and keen observational skills. It would be even better if they can communicate well with patients and their families.
The breakthrough in many difficult cases could often be due to a small detail mentioned by the patient or their family, or a symptom that is hard to articulate, discovered during communication.
"Today was truly an eye-opener! I didn’t even consider this angle back then and kept worrying that the child might have ruptured a deep artery, causing intracranial bleeding. Who would have thought it was ITP!"
Dr. Shao looked at Li Jingsheng with a hint of admiration in his eyes.
He had been at Sunshine Clinic for only a few days.
But Li Jingsheng had already demonstrated wisdom beyond his years in multiple areas of internal medicine compared to this seasoned doctor.
Young, knowledgeable, and with cutting-edge clinical diagnostic thinking, such a young doctor has limitless potential!
"Doctor, can you help check my child’s ears? Recently, the teacher reported that she has been inattentive in class and often daydreams. When I call her from behind, she seems not to hear. I’m worried there might be an issue with her hearing."
A mother in her thirties brought in an eight or nine-year-old girl for consultation.
Patients coming to the clinic are generally of a few types.
One type seeks affordability, with poor or moderate financial conditions, fearing the high costs of a hospital visit.
Another type seeks convenience, living nearby, and prefers visiting the clinic without having to queue.
In fact, before Dr. Shao’s recruitment, Sunshine Clinic already had long queues and long waits for consultation.
However, now with three doctors in attendance, this situation has greatly improved.
Some elderly people do not understand the registration process, let alone the blood tests here and checks there in big hospitals, and are afraid to go to a hospital without their children by their side. Therefore, they visit the clinic instead.
It’s more affordable and avoids many complicated procedures.
The third type comes for trust, possibly also due to convenience and affordability.
Basically, these are the three types of patients.
This mother probably came to the clinic for the sake of convenience and cost-effectiveness.
"Young lady, please close your eyes!"
Li Jingsheng said to the girl.
She closed her eyes.
"How old are you?"
"Nine!"
"What grade are you in?"
Li Jingsheng deliberately lowered his voice.
"I couldn’t hear you, could you speak louder?"
"I asked what grade are you in?"
"I’m in third grade."
"What’s your name?"
This time, Li Jingsheng asked from her right side.
No response.
"What’s your name?"
This time, he switched to her left side.
"Wang Chunlan!"
She could hear clearly.
Li Jingsheng had an idea in mind.
"Okay, open your eyes! Have your ears been feeling uncomfortable lately?"
"Not really, just sometimes my right ear feels a bit itchy."
"Have you cleaned your ears?"
"I picked at it with my finger."
"Is there any discomfort in other parts of your body?"
"No."
Up to this point in the inquiry, Li Jingsheng basically determined that the issue was with the girl’s right ear.
"Come closer, let me check your right ear."
He used a small flashlight to examine the child’s right ear, finding it mostly blocked by something black.
It didn’t appear to be blood and seemed to be earwax.
"Please lie down on that bed! There’s a foreign object in your ear, I’ll use tweezers to remove it for you."
Two treatment options quickly ran through Li Jingsheng’s mind.
Use tweezers to extract it, or apply a 5% sodium bicarbonate solution to the ear to soften the earwax, then have the child come back after a few days to wash the outer ear canal.
The first method is efficient and quick, and it is also cheaper.
The child will endure less discomfort.
After having the child lie down, he turned and called Han Siying, "Siying, come over and stabilize this little girl’s head."
Whenever she had spare time, she would run into the pharmacy area to sell medicines.
It’s indeed quite busy over there.
Of course, her eagerness is largely due to the considerable commission from selling medicines.
After attending to a customer, she hurried over to help.
"I’m going to remove the earwax from the child’s ear; make sure to keep her head steady so she doesn’t move."
"Understood!"
She nodded in agreement.
Removing foreign objects from the ear can make a child feel itchy or painful, causing them to fidget.
This could easily injure the outer ear canal, or even the internal canal, including the eardrum.
Safety is a concern that cannot be ignored.
After Han Siying stabilized the girl’s head, Li Jingsheng cautiously proceeded to extract the object from her ear canal.
It felt especially hard and was tightly lodged.
It could be related to the girl’s habit of picking her ear with her finger.
This only pushes the earwax deeper and compacts it tighter.
The ear canal naturally secretes ’earwax,’ and this is more serious with oily ears.
Under normal circumstances, the ear canal has its own self-cleaning mechanism.
