The Enhanced Doctor

"Alright, let’s go, be clear about the objective, biopsy is the only option." Liu Banxia said.

"However, we also need to explain the risks of biopsy to the patient, after all, from our medical perspective, the risk of biopsy is greater than enhanced CT."

Xu Yino nodded, "Teacher Liu, actually, I think you should try a little harder; what if your persuasion works?"

"Do you really think it works?" Liu Banxia retorted.

Xu Yino remained silent, she knew the possibility was very low, yet it was still a hope, wasn’t it?

Approaching the patient’s bedside, the family of three appeared worried. Even the most optimistic person can’t ignore the potential of having a malignant tumor.

"Doctor Xu has just explained the situation to me. Currently, based on the examination results, although there is a possibility of a metastatic tumor, we haven’t made a conclusive diagnosis. We must preserve our confidence." Liu Banxia said.

"Doctor, isn’t there any other way to check? Can’t you conduct more tests? Or do an MRI?" The patient’s husband inquired.

"For tumor detection, the primary methods are enhanced CT and biopsy; plain CT and MRI can only reveal the presence of a mass, but we can’t determine the exact cause of the mass." Liu Banxia explained.

"Her case is a bit unique, so let’s go over it from the beginning. Firstly, there’s ’successful weight loss,’ which could be caused by malignant tumors, but it might also be due to diabetes itself."

"With hemoglobin A1c levels so high, we can be certain there is diabetes. Diabetes has numerous complications, one of which is weight loss. Hence, when two possible causes affect her, we should lean towards the primary cause for judgment."

"Additionally, despite the kidney mass and multiple lung nodules, we can still consider inflammation. Given that you still have a fever, the likelihood of an inflammatory response is greater."

"Doctor, so biopsy is the only option? Can I do it directly?" The patient asked.

Liu Banxia nodded, "Biopsy entails directly sampling the mass. We will generally collect multiple specimens to avoid not being able to detect due to insufficient samples."

"However, this kind of puncture diagnosis method inherently carries certain risks, even more so than enhanced CT."

"Therefore, you need to decide between these two testing methods yourselves. Additionally, given the current situation, I recommend that you be admitted to the hospital for treatment."

"At the very least blood sugar needs adjustment, fever needs control, and antibiotics may be necessary for anti-inflammatory purposes. After biopsy, movement should be minimized, so if anything arises, it can be addressed promptly while at the hospital."

"So even if a biopsy is performed, there is a possibility of not detecting anything?" The patient’s husband asked.

Liu Banxia nodded, "That’s why we need to collect multiple specimens, to avoid such occurrences."

"What about tumor marker screening? Doesn’t that specifically detect tumor types?" The husband continued.

"It’s only an auxiliary method, providing guidance during numerous examinations and corroborating other tests."

"For example, after an enhanced CT, if we preliminarily determine a malignant tumor, we can compare with tumor marker screening."

"We can use tumor marker screening results to decide whether to conduct enhanced CT or biopsy, to prevent misdiagnosis or missed diagnosis."

The couple exchanged glances, realizing that biopsy indeed carries significant danger.

"Doctor, do you think we should proceed with the biopsy?" The wife of the patient asked.

"If you are asking for my recommendation, I’d suggest enhanced CT. But given your apprehensions, biopsy is the only way to clarify the situation." Liu Banxia replied.

As he said, there was no further discussion about enhanced CT. The patient’s family was resistant to enhanced CT, and with indications of a malignant tumor in the patient’s current examination, biopsy became the only recommended option.

Even if biopsy provides a definite diagnosis and confirms malignant tumor metastasis, subsequent treatment may not be highly effective but at least treatment strategies will be better directed.

"Alright, let’s proceed with the biopsy. Can it be done now?" The patient spoke.

"In the afternoon; for now, you should have a meal and perform some training. Stick to liquid meals, don’t eat to full, just have a light bite." Liu Banxia advised.

"Let’s first handle the admission procedures, then go to the cafeteria for lunch, where porridge is available. After returning to the ward, inform the nurse for the afternoon kidney biopsy, and they will manage it accordingly."

The patient nodded, having made the decision, there was no point in hesitating further.

"Sigh... the patient’s family is really resolute." Xu Yino sighed after stepping out.

"We have no choice but to respect the patient’s choice, even if our medical knowledge tells us that enhanced CT is less invasive compared to biopsy puncture." Liu Banxia said.

"This is a common occurrence during our consultations, patients sometimes prefer MRI, believing it’s superior; aside from explaining, we must cater to their requests."

"Our purpose is to serve the patients, their requests take precedence. Even if their requests contradict our medical knowledge, if we don’t cater to their feelings, they may not be reassured."

"Such patients are always better than those who resist examinations and do nothing. After eating, prepare for a renal biopsy, any issues?"

Xu Yino shook her head, "This should be much simpler than a spinal puncture, and it’s performed under ultrasound, so there shouldn’t be any problem."

"Be confident, the main concern is the post-operative precautions; make sure to thoroughly explain them to the patient. Otherwise, if blood appears in the urine, the patient might be frightened," Liu Banxia said.

Xu Yino nodded; indeed, the care following a kidney biopsy is crucial.

"Shall we go eat then? Will the biopsy still proceed for that patient?" Wang Chao asked.

"Yes, as she’s genuinely afraid of enhanced CT," Liu Banxia said smilingly.

"But I have a feeling the chance of the patient having a malignant tumor isn’t high; it might just be inflammation. However, a biopsy is still needed for confirmation, as the mass in the kidney is rather large, and she barely feels any discomfort."

"When technology advances a bit more, we’ll be able to test everything with just a blood sample. That’s convenient for both us and the patients," Wang Chao mused.

Liu Banxia laughed, "That’s up to you to develop; I doubt others can. You have to work hard for it."

"No rush, we’ll certainly achieve it someday. Technological advancements often exceed people’s expectations by far," Wang Chao replied cheerfully.

Chatting casually, they arrived at the cafeteria, which was quite busy.

During the New Year period, work tends to slow down, so everyone follows the schedule for meals, making it more concentrated.

Xu Yino accelerated her eating pace today, needing to prepare for the kidney biopsy.

As she was eating, the son of the cirrhosis patient came looking for them.

"Have you made a decision?" Liu Banxia inquired.

"We’ll use my liver; no matter what my sister says, my liver will be used. I’ve persuaded my dad, he’s willing to accept the transplant," said the patient’s son.

"You still need to discuss it well with your sister; it’s a decision you can’t make alone. We’ll arrange for you to complete the hospitalization procedures tomorrow afternoon," Liu Banxia advised.

"Actually, having you hospitalized is to prevent other complications during the wait for the transplant. If you get infected with another bacteria by then, we’ll have to prepare all over again."

"Doctor, can’t you help come up with a reason?" the son hesitantly asked.

"How could we make one up? We need to remain objective," Liu Banxia insisted.

"We understand you want to take your sister’s feelings into account, and as I’ve mentioned, post-operative care is also taxing. It requires someone to care for him specifically; it’s not easy."

"Talk to your sister properly; consider the future, or even the financial aspect. Although this surgery carries risks, they are quite minimal."

The patient’s son nodded and left the cafeteria.

"If he doesn’t work things out with his sister, she might come to confront you," Wang Chao predicted.

"Indeed, it’s the first time we’ve encountered such a situation despite hearing about it often before," Liu Banxia reflected.

"It’s touching for both Liu Yiqing and me. This is how a family should be; we’ve seen too much negativity and need some positive energy to counter it."

"Our expectations are modest anyway; we don’t need everyone to make sacrifices, nor can we achieve that ourselves. But at the very least, we can do whatever is within our capacity; show a little kindness."

Wang Chao nodded, which is why he enjoys spending time in the emergency center.

Working in hospitals, you inevitably encounter too much negativity. In the emergency center, Liu Banxia at least occasionally provides some laughter to ease emotions.

Otherwise, it would be oppressive to be constantly surrounded by such negativity. Over time, it would undoubtedly lead to psychological issues.

That’s why patients sometimes feel the attending doctors are "insensitive," because they witness too many things regularly.

Just then, Liu Banxia’s phone rang, he saw it was Qi Wentai calling, and hurriedly answered, "President Qi, go ahead."

"We’re about to send over a patient injured by an exploding tire; the situation is quite severe," Qi Wentai said.

"OK, I’m on my way,"

Finishing the call, Liu Banxia ran straight to the emergency center.

The impact from a tire explosion is akin to a small bomb.