Practicing Medical Skills in a Small Clinic

The patient’s sister agreed directly.

Coming to the Sunshine Clinic for treatment, obviously reflects a level of trust.

When the doctor suggests any examinations, the patient and their family usually consent as long as they can afford it.

Unless certain invasive tests pose risks that frighten them, they might refuse.

After taking a chest X-ray for the patient, Li Jingsheng discovered total atelectasis and even nodular shadows in the lungs.

Pulmonary interstitial fibrosis is also quite severe.

No pleural effusion or infiltration shadows were found.

Based on his experience, this patient’s condition is much more severe than initially expected.

However, his small clinic’s limited capabilities can’t proceed with further examination.

Initially, he merely suspected the patient had chronic respiratory failure, so he wanted to take an X-ray to check the lung condition. In fact, the best way to diagnose respiratory failure is through arterial blood gas analysis.

He cannot perform this test here, and can only use other methods for diagnosis.

Imaging tests, whether X-ray or CT, help doctors pinpoint the causes of respiratory failure.

For instance, this patient’s respiratory failure cause has basically been identified.

Total atelectasis, lung nodules, and pulmonary interstitial fibrosis are the primary causes of respiratory failure.

After bringing the patient back to the outside consultation desk, Li Jingsheng looked at the patient’s sister.

"Just took an X-ray, found nodular shadows in the lungs, the condition is a bit complex, our clinic’s limitations suggest you go to a major hospital for further examination."

Li Jingsheng spoke rather tactfully.

In practice, doctors always try to speak gently directly to the patient.

Especially with severe conditions, they generally won’t tell the patient outright.

Some patients with poor health and weaker mental fortitude might struggle to cope with hearing about serious issues, such as cancer or major illnesses.

They might break down immediately.

Some might even collapse then and there.

Especially patients with bad hearts, high blood pressure, or severe intracranial arterial sclerosis, and cardiovascular hardening, they cannot bear such shocking news.

Elderly patients also face similar difficulties.

"Going to a major hospital for treatment is too expensive, can you treat it here?"

The patient clutched his chest and gasped forcefully.

Already at thirty, his health is so deteriorated, at least he’s fortunate not to be married, otherwise a wife and kids would be burdened.

"Go see a major hospital first. If you need medicine or injections later on, you can come back to our clinic."

Li Jingsheng advised the patient.

Ultimately, the patient’s sister supported him as he left.

A few minutes later, his sister returned.

"Dr. Li, with my brother present earlier, you might have spoken cautiously. Could you tell me the truth now? My parents are old and sick. I am the one handling my brother’s matters."

As a sister, she showed remarkable responsibility.

"May I ask, are you married?"

"Yes, my child is already over seventeen."

She clearly misunderstood.

"Your brother might have a serious illness. During the X-ray, the nodular shadows I saw, regardless of shape, size, or density, didn’t look good. Since he has had this illness for years, if it were merely chronic respiratory failure, he could be treated here at my clinic. But in case it’s a lung tumor or similar, further tests at a major hospital are needed to assess the tumor’s nature and check for any spread.

Some things I shouldn’t say, but I must mention that early-stage malignant lung tumors have a chance of surgical cure. If it’s at a later stage, then family finances must be taken into consideration.

What I’ve seen most often is the loss of both people and finances."

Li Jingsheng could only hint this gently.

From the looks, the sister deeply cares for her brother, akin to parental care.

This is the sorrow of parents overly pampering their son from childhood.

It’s not definitive that the lung disease is caused by nose humming. At least, excessive parental spoiling plays a role.

Excessive pampering weakens his competitiveness in society, allowing him to indulge excessively.

Smoking, staying up late playing games, and other behaviors might trigger lung tumors.

"Thank you!"

The patient’s sister walked out of the clinic’s consultation hall with tears in her eyes, taking out a tissue to wipe them.

Perhaps freshly wiped tears emerged again, she stood at the entrance, repeatedly wiping her eyes for more than ten times before she got her emotions under control and walked away.

Witnessing all this, Li Jingsheng sighed deeply.

The scourge of disease is indiscriminate, choosing no gender, age, wealth, or status; it attacks humanity without mercy given the chance.

Misfortune especially hits those with hard fates.

The poorer one is, the more diseases tend to target them.

For instance, people with weak or average financial conditions; seven out of ten are quite frugal.

Being frugal itself isn’t a bad thing.

However, lurking crises sometimes hide within seemingly good frugal actions.

Many can’t bear to discard leftover meals.

Especially those over fifty, having endured periods of hardship. They view wasting leftover food as unacceptable.

People from that era have special sentiments toward food.

Unbeknownst to them, with improved living conditions nowadays, consuming leftover meals has become hazardous.

Research indicates that prolonged leftover food may contain many nitrosamines.