Practicing Medical Skills in a Small Clinic

"Teacher Li, let’s start calling the numbers!"

Li Jingsheng said to Li Li.

A female patient in her forties was directly pushed in, lying on a flat bed, her face full of pain.

Unable to walk at all, indicating the injury is either in the lumbar spine or the cervical spine.

The patient can move her head, and her upper limbs can be placed on her chest, indicating no issues with the upper body.

So the problem is most likely in the lumbar spine.

For patients over forty, the probability of lumbar spine problems is much higher than for younger people.

Especially for those engaged in heavy physical labor or work requiring bending, diseases like lumbar disc herniation are more likely to occur.

"Is it the lumbar spine?"

Li Jingsheng directly asked the female patient.

"Yes, my wife’s lumbar spine was injured before, after nearly a year of recovery, there were no issues. Could work normally. Didn’t expect this time it suddenly hurt so much she can’t even walk."

The male family member also seemed to be in his forties, a very straightforward big brother.

Dressed simply, with rough hands and sturdy fingers.

Indicating he usually does heavy physical work.

Five students stood neatly behind Li Jingsheng watching.

Seeing the teacher identify the patient’s issue at a glance, they couldn’t help but admire him more, filled with respect for Li Jingsheng’s medical skills.

"Have you taken any films?"

"We have! It was taken at your hospital today. Professor Zhong is very nice; after looking at the film, he told us to consult you first. He said that if you can treat it with manipulation, my wife wouldn’t need surgery."

The man’s eyes looked eagerly at Li Jingsheng.

Full of hope in his gaze.

Surgery not only carries high risks but also greatly increases the treatment costs.

If Li Jingsheng could help his wife with manual realignment, that would be ideal.

"Oh dear, your wife’s condition is serious! The lumbar disc has already slipped out."

After reviewing the film, Li Jingsheng slightly furrowed his brows.

Lumbar spine manipulation is inherently high risk and difficult.

It’s not as simple as forcefully pressing it back in.

Some charlatans pretend to restore fake patients with flashy stunts. Lumbar disc herniation pressed back directly, and the patient seems cured on the spot.

Not saying it’s impossible, but at least most of these patients cannot be treated with manipulation.

Forcibly pressing it back is inconceivable.

The spinal nerves are within the triangle bone chamber.

Violent actions could injure the spinal nerve, leading to immediate paralysis. Extremely dangerous.

Many patients with lumbar disc herniation have degenerative nucleus pulposus changes, ruptured annulus fibrosus, or proliferation, etc.

The pain is because the spinal nerve is being stimulated or compressed.

There are many options for conservative treatment, which are gradual, not rough quick fixes.

Li Jingsheng has seen particularly severe cases where sacral tissue protruded directly from the ruptured annulus fibrosus. Some even extruded into the spinal canal.

In such cases, forcing it back would worsen the ruptured annulus fibrosus and may cause severe spinal nerve damage.

Therefore, when faced with lumbar disc herniation or cervical spine issues, never believe the nonsense of quacks.

Cases of patients being pressed into disability are not uncommon.

Although many criticize official hospitals for being expensive and ineffective even after surgeries, in terms of safety, formal hospitals are certainly much better.

To put it simply, you can’t run from the monk but not the temple.

If something goes wrong, you can hold the hospital accountable.

Hospitals may seem profitable, but they definitely can’t afford multiple compensation cases!

Surviving hospitals, especially public ones, are generally reliable and trustworthy.

Some reputable private hospitals are equally trustworthy.

In terms of skills, they might even surpass public hospitals.

Though such instances are rare.

In the current domestic scenario, the majority of highly skilled doctors are concentrated in public hospitals.

Especially in top-tier institutes.

"Dr. Li, please think of a way to help! I usually wash dishes at a restaurant, earning just over two thousand yuan a month. I have two kids and two elderly people at home, and my husband’s health isn’t great either. If we need surgery, I’m afraid it’ll ruin our family."

The female patient endured the pain in her lower back, pleading with Li Jingsheng to help her.

Many families have children and the elderly to support, with the couple’s low income and health issues, it only adds to their misfortunes.

"I’ll certainly come up with a solution if there is one. I grew up in the countryside, so I know how hard it is for every family."

Li Jingsheng reassured the patient.

"Normally, the disc wouldn’t slip out like this! Before it happened, you must have had some symptoms. Please describe in detail how your illness developed!"

Director Zhong is an excellent doctor, except for being a bit impatient, otherwise impeccable.

He doesn’t just delve deeply into medical skills with high professional standards but is exceptionally kind to patients.

With a heart as benevolent as a Bodhisattva.

If he could help save on medical expenses or find a better treatment path, he would inform patients and their families.

Helping them avoid detours.

Pointing this patient to Li Jingsheng, Zhong Hu was also a bit uncertain in his heart.

Because this patient’s condition is indeed quite severe.

"I remember in the beginning, maybe after washing dishes, as I quickly stood up holding a stack of plates, I felt a slight swelling pain in my waist, not serious. Later, I was still worried about worsening it, knowing my back isn’t good.

When carrying the washed dishes to the cupboard for disinfection, I tried to take fewer each time, making multiple trips.

Unexpectedly, the next morning after sleep, the lumbar spine pain was severe, making walking even difficult.

When walking, it feels like one step is higher than the other.

My husband noticed my walking posture was strange and asked me what was going on."

At this point, the patient should already be limping.

"The next day, besides having difficulty walking, I needed a bit of effort to straighten my back, and it was particularly painful. Later, I was afraid of worsening the condition, so I called my boss to take leave.

Because it was too painful, I could only lie in bed.

The problem was that whether I was lying down, sitting, or standing, my back was continuously in pain. It was a throbbing pain, as if someone was sawing my back.

By the second night, I noticed it was also particularly painful when I coughed.

Today, my husband brought me to the hospital.

We heard that you are very good at treating bone injuries and diseases here, so we called a cab first thing in the morning to come over."

The female patient roughly described the onset of her illness.

The onset was rapid.

She should have taken leave and gone home to rest as soon as she first felt the swelling pain in her back.

But most people would grit their teeth and finish their work.

Because work is not easy, and making money is even harder.

Taking leave would mean worrying about the boss docking pay.

No one else would take over the work in hand.

Li Jingsheng listened and then had the patient lie on her side.

When helping her turn over, the patient let out painful groans.

"Let me check your bones first, it might hurt a little, please bear with it."

Li Jingsheng lifted the patient’s clothes to reveal her back.

Her body type was quite plump.

Even while lying on her side, her belly fat was clearly visible, hanging down in a lump.

At this moment, the patient needed to hunch slightly to ease the pain.

Her lumbar spine showed obvious protrusion.

"You can pay close attention to the protrusion of the patient’s lumbar spine, and then look at the patient’s scans, so in the future when encountering similar cases, you’ll have some experience."

Li Jingsheng told the five students.

Dr. Chen was currently holding the scans, looking exactly like the senior disciple among the five.

The five students had varying reactions, but Ye Hui was quite bold, already moving closer to watch the scans with Dr. Chen.

By now, they had almost seen enough.

So they crowded around to watch Li Jingsheng examine the patient’s bones.

"If it’s a severe case, the patient’s spine might exhibit an S-shaped deformation. This patient’s condition is still relatively good. But in this position, next to the spinal processes, you each can have a feel."

Li Jingsheng instructed the six students.

Dr. Chen took the initiative, being the first to have a feel.

With some practical experience, the old doctor showed excellent skill in pressure and touch techniques.

"Let me have a feel too."

Ye Hui couldn’t resist her curiosity and reached out to touch after Dr. Chen was done.

Though the patient and her family were somewhat displeased, they didn’t object.

They still needed Li Jingsheng’s help for treatment, so naturally, they wouldn’t dare offend the doctor.

One male student was quite rough while touching, and Li Jingsheng quickly stopped him.

"Yang Luqing, next time be gentler when checking a patient. Remember, feeling the bones or other lesions doesn’t always require a strong press to sense the shape and nature of the lesion. Instead, you need to feel it with care, and conduct a comprehensive evaluation from the sensation, softness or hardness, surface smoothness, and whether it is a movable lesion."

As a teacher, Li Jingsheng must certainly teach his students well.

Otherwise, it would harm people in the future.

"I’ll definitely pay more attention next time."

Yang Luqing, after being criticized, slightly lowered his head, his face a bit red.

Being criticized by a teacher on the first day of learning, in front of so many people, is definitely a bit embarrassing.

But there’s no way around this.

No clinical medical student has never been scolded.

If you’re too sensitive, you’re simply not suited to being a doctor.

"You all have felt it, share your thoughts."

"What I felt kind of seemed like a protruding lumbar disc, but the texture didn’t quite match." Dr. Chen was the first to speak.

"It felt like a spasm nodule!"

Ye Hui eagerly answered second.

"It should be a mass caused by a hematoma."

"Could it be varicose veins?"

Hearing these responses, Li Jingsheng was quite speechless.

What wild imaginations, even bringing up varicose veins.

Only Ye Hui’s answer was relatively accurate.

This also made Li Jingsheng appreciate her a bit more.

All teachers are the same; they invariably like students with talent.

"Anything else you noticed?"

Li Jingsheng asked the six students.

Each one shook their head.

Earlier, through examining the bones, Li Jingsheng also discovered atrophy in the muscle on one side of the patient.