Practicing Medical Skills in a Small Clinic

Li Jingsheng always considers and thinks on behalf of the patients.

This increased the trust patients and their families had in him by several degrees.

"Dr. Li, we are country folk and don’t understand much. This is a small token of appreciation from me, just consider it a drink on me."

The patient’s husband pulled out two red bills, trying to slip them directly into Li Jingsheng’s pocket.

"Brother, we have rules; we can’t accept money or gifts from patients and their families. Please don’t make it difficult for me."

Li Jingsheng returned the money to him.

"Please don’t think it’s too little. This is just a token of appreciation. If you can cure my wife, you’ll be doing my family a huge favor."

The man’s words were too candid.

To put it bluntly, he’s trying to offer a gift so that Li Jingsheng would treat his wife more diligently.

"Brother, we really can’t accept gifts!"

"It’s okay, it’s okay, even if your director comes, I’m not worried. This is given willingly. Surgery costs tens of thousands, and there’s even a risk of lifelong paralysis. If you can help my wife with direct manual therapy and it works, think of how much you’d save my family! It’s just because we’re not well-off, otherwise, I’d definitely give more."

The altercation drew considerable attention from the crowd.

Li Jingsheng didn’t refuse anymore.

Instead, he accepted the money first and then began treating the patient.

"Dr. Chen, help me move the patient to the treatment bed inside."

Li Jingsheng called on the more experienced Dr. Chen.

Transferring a patient with a herniated lumbar disc requires certain expertise. If mishandled, it can exacerbate the patient’s injury.

He didn’t dare call the five new trainees.

Just like accident trauma patients, when conditions allow, it’s best not to move them without caution.

Because the extent of the injury is unknown, recklessly moving an injured person can easily cause secondary damage.

Such a tragedy has happened, even leading to court disputes later.

It started when an elderly woman was hit by a car while crossing the street.

She fell to the ground and couldn’t move.

It was a busy traffic intersection, and kind-hearted passersby worried she might be run over again by cars, so they moved her to the roadside.

Soon after being moved to the roadside, the elderly woman died.

Subsequent forensic analysis revealed the cause of death was a broken rib piercing her heart.

When the family sought accountability from the driver, the driver stayed silent.

The woman hadn’t died initially; it was when passersby moved her to the curb that led to her death. The driver believed that the movement might have caused the rib to pierce her heart, ultimately leading to her demise.

Each side believed they were right.

It eventually turned into a confounding account.

The two well-intentioned passersby were each ordered to pay the deceased’s family ten thousand yuan.

This was primarily because their actions were motivated by goodwill.

Otherwise, the judge might not have ruled this way.

The two passersby could have ended up paying even more.

What the two passersby found hardest to accept was that after compensating, the family still berated them, accusing them of meddling and even calling them murderers.

So, when encountering victims of car accidents or falls, it’s best not to move them recklessly.

After Li Jingsheng and Dr. Chen moved the patient to the treatment bed inside, the five trainees crowded the doorway to watch him work without needing an invitation.

"I’m going to perform a side-bending manual therapy for the patient now; generally, the patient should be in a prone position. During the procedure, take special care to protect the patient’s lumbar spine to avoid secondary injury."

Li Jingsheng explained the operational essentials to them.

He covered key points about moving the patient and assisting them in turning to a prone position.

"How do you feel now?"

He stood at the side, preparing to start the treatment.

"It hurts, my lower back feels swollen and painful, also a bit sore! It’s very uncomfortable!" The patient’s speech was somewhat labored, constantly sucking in air and groaning.

"I’ll start treating you soon, relax, try to relax your whole body; if you tense up, it might hinder the treatment."

Li Jingsheng instructed the patient.

In many situations, doctors and patients need to mutually cooperate and trust each other.

He felt that the patient had adjusted their mindset and was fully relaxed.

"You all saw the patient’s scans earlier and felt her lumbar spine. Which side is injured?"

"Left side!"

"Right side!"

The trainees’ responses made Li Jingsheng’s forehead crease with lines of frustration.

"Actually, the patient’s injury is slightly on the right side, so during treatment, we place our hands on the patient’s left shoulder."

He placed one hand on the patient’s left shoulder.

The other hand was placed next to the spinous process.

As soon as his hands were positioned, before applying pressure, the patient began to exclaim in pain.

"Dr. Li, please be gentle!"

The patient’s husband anxiously tiptoed outside, straining to see in.

"Okay, I’ll be precise with the force!"

Li Jingsheng chose not to administer anesthesia to the patient.

He had his comprehensive reasons.

Given the patient’s condition, spinal anesthesia was not suitable.

General anesthesia wasn’t necessary either.

Local anesthesia was virtually ineffective.

And the pain duration was very brief; he believed it was within human tolerance.

Plus, the patient’s family was not well off, and faced financial burdens; he wanted to help save them some costs.

General anesthesia would significantly increase the expense.

He pressed down on the patient’s spinous process, using the heel of his hand to firmly apply pressure, then pushed toward the left side.

"Dr. Chen, remember to use the heel of your hand to exert force, pushing the spinous process toward the healthy side. The force should be just right—not too heavy or too light. With more experience and proficiency, when dealing with children or frail patients, you can use your thumb instead of the heel of your hand to operate."