Free Web NovelChapter 1116: Chapter 1116: Time to Unleash the Ultimate Move
"Alright, time’s up. Early in the morning, why are you all so drowsy? Perk up, perk up, there are patients waiting for your treatment."
Liu Banxia glanced at his watch, stood up, and clapped his hands.
"Your state is lacking, you’re too rational during discussions. The volume in this room is definitely not high enough, not even reaching the standard of a vegetable market."
"When discussing issues, unless you’re always a slow-paced person like Liu Yiqing, you need to bring out your emotions, only then can you convince others."
"Haven’t you all watched debate competitions? You must have your own momentum. Without a definitive diagnosis for the patient, how do you know if your chosen path is correct?"
"Like bringing a slow doctor to an urgent illness, this won’t do. You’ve discussed for so long, shouldn’t you come up with some ideas? Do you have any thoughts? Be bold."
Hearing his words, these interns and resident doctors all looked at him in unison, but no one spoke.
"Doctor Xu, how about you say a few words?" Liu Banxia looked at Xu Hui.
"I’m not going up there. Anyway, it’s your initiative, so you should wrap it up." Xu Hui quickly shook his head.
"Then I’ll say it. Actually, up until now, Doctor Xu and I haven’t any concrete direction on the patient’s condition." Liu Banxia said with a smile.
The interns and resident doctors were dumbfounded. What’s he on about? Didn’t he just say there was a direction? Is he messing with us? Can’t be, right?
Seeing their expressions, Xu Hui helplessly shook his head.
Following Liu Banxia, they couldn’t tell if it was their fortune or the beginning of their torment. Always so playful, unknowingly trapping you.
"Why the face? I’m not wrong, and you didn’t hear wrong. We really have no direction, but we can guess." Liu Banxia said earnestly.
"My wife put it well, magic tricks’ success depends on keeping them under wraps. The quality of medical skills depends on your guesswork. You could say it’s our doctors’ big trick, specifically treating various complicated and tricky diseases."
Forget others, even Xu Yino was a bit dumbfounded. Doesn’t this sound like those selling fake medicine in the martial world? Is Teacher Liu just happy and rambling nonsense because of the baby?
"Considering this patient, the little friends just now all had ideas. But their ideas weren’t firm, if you can’t convince yourself, how can you argue with others?" Liu Banxia continued.
"The symptoms exhibited by the patient are very complicated: fatigue, coughing up blood, lung inflammation, anemia, mouth ulcers, low fever. These symptoms are intertwined, much like the celebrity dating histories we’ve seen online, relating to everyone in some way."
"Currently, our diagnostic direction has arrived at a crossroads, surrounded by darkness. Cui Jia illuminated her phone, thinking it was an urgent academic issue."
"This is also very possible, but to investigate thoroughly, a bone marrow biopsy is needed for the patient. The indication isn’t very clear, and invasive tests should be approached carefully."
"Chen Jun lit the torch, suspecting the patient’s pneumonia was caused by a drug-resistant bacterial infection. But until the culture results come out, we still have to wait."
"But we can’t wait anymore, there’s already a low fever, indicating the condition has become tense to a certain degree. And we’ve waited a whole night, waiting any longer will cause the patient to lose confidence."
"So what’s Doctor Xu’s big move?"
At this point, Liu Banxia paused.
The people below eagerly looked at him, these were also detailed explanations of the patient’s situation and the concerns everyone had in mind.
"Listen carefully, keep it in your heart, what is it? It’s a rheumatology immunology test." Liu Banxia said solemnly.
"Why are your eyes so wide? Given the patient’s situation, are we not in a predicament and should we not check this?"
"Am I not right? Among all the tests we’ve done, we’ve focused on the blood, focused on the lungs, but haven’t we overlooked this?"
"Teacher Liu, so it’s a rheumatology-related disease?" Xu Yino asked.
Liu Banxia calmly shook his head, "We’re not sure, that’s why the test is needed. The patient’s symptoms are deceptive, so we lean towards the possibility of this category of disease being higher."
"But what follows is also key, if we have this inclination, then the patient needs a more comprehensive physical examination. Who can tell me what a typical presentation of such symptoms is?"
"Joint pain, rashes, fever."
Xu Yino reacted quickly.
Liu Banxia nodded, "Indeed, these are typical symptoms. But because these symptoms are so typical, when we encounter such patients, we’ll think of it quickly."
"However, the complexity of such acutely ill conditions stems from many non-specific manifestations. Also, the human body is amazing, responding instinctively to various diseases with immune reactions."
"Even if his immune system is riddled with holes now, it’s still fighting for this body. Some symptoms may not be noticeable to the patient, or some may not even manifest."
"Of course, we can’t turn rheumatology immunology screenings into routine checks right off the bat for every patient. That’s inappropriate and would lead to complaints."
"We conduct the necessary examinations based on indications. The reason a big move is a big move is because it’s used when there’s no other move to make."
"Xu Yino, lead the female classmates to perform a physical examination on the patient. After the exam, clarity on symptoms is better, but even if there’s none, we can proceed with the rheumatology immunology screening."
"Okay, we’ll go right now."
Xu Yino responded cheerfully.
Even though no examination has been conducted yet, she also thought the likelihood of the patient having a disease in this area was very high. However, the necessary tests still must be conducted to make the indications clearer.
"Can’t you just tell them directly to calmly perform the examinations?" Xu Hui asked after everyone left.
"You didn’t say anything, so I had to use this style. Do you think the possibility is high?" Liu Banxia asked.
"I think it’s about right, very likely systemic lupus erythematosus, just in the early stages, so the manifestation isn’t very obvious." Xu Hui said.
"But that’s just our speculation, still need to wait for test results. If they still don’t yield results, what are you planning to do next?"
"What else can we do? Bone marrow biopsy is the way, we must get to the bottom of the anemia issue." Liu Banxia said.
"Then it’ll be a hassle, having to tackle each element one by one, who knows when the real diagnosis will reveal itself. Wait patiently for test results, there’s no other solution."
Xu Hui nodded in agreement.
For now, it’s the best course of action anyway, as both he and Liu Banxia could think of this direction.
He wasn’t idle yesterday either at home, pondering this patient’s situation. With symptoms so vague, he could only think more deeply.
If we are to consider all symptoms as external manifestations of some disease, it aligns well with the presentation of rheumatology-related diseases.
But without some typical symptoms, it remains a backup option, as Liu Banxia called it, the big move.
Meeting with Liu Banxia early this morning, the two of them, it seemed, were on the same page. So during the ward round this morning, they paid special attention to the patient’s face.
Though there was some makeup, if there really were rashes on the face, they would be noticeable. Facial rashes are a significant external indicator for many acutely ill rheumatology diseases.
"Nowadays many illnesses really aren’t so easily diagnosed." Xu Hui sighed.
"That’s why we doctors need to take a guess," Liu Banxia self-deprecatingly remarked.
"I actually think my wife’s words make a lot of sense. For a complicated and tricky disease without clear indications, you need to guess."
"Although we have some medical knowledge, our guesses have a bit more reliability. I even thought of one possibility: if the patient were to put all these symptoms online for information, what kind of conclusions might they draw?"
"Based on the online consultation habits, wouldn’t it directly get classified as an immunological acute disease? Would we have considered it if she had mentioned it on her appointment?"
"Honestly, getting medical information online might not be a bad thing. For some patients who like to delay treatment, if they first self-examine online, wouldn’t they delay less?"
Xu Hui shook his head helplessly, "I don’t have as many thoughts as you, I need to get to work, can’t waste any more time. Don’t you have two surgeries tomorrow? Prepare well."
"Those two surgeries tomorrow aren’t very complex, just routine ones. A careful look at the colonoscopy and rectal MRI images will do." Liu Banxia said.
Xu Hui felt even more helpless, also aware of Liu Banxia’s knack, feeling a bit demoralized even though he’s not a surgeon.
Others find it hard to master a single surgery, while Liu Banxia seems to do so effortlessly.
TaTME surgery is part of the NOSES operation, with higher difficulty. Yet he’s grown fond of this surgical method, opting for it whenever possible.
This is the difference between natural talent and daily effort. Even helping ponder other patients’ conditions while doing surgeries, it looks like he might cross-domain in the future.
Unbeknownst to Liu Banxia of Xu Hui’s many musings, not long after arriving, he also thought about his two babies.
Even so, there’s nothing he can do, as a deputy director, he can’t just wander into his wife’s ward without cause. That would become a habit, creating a bad influence.
Even if others say nothing, one must pay some attention personally.
