The Enhanced Doctor

(Thanks to Lu Hongzhang and reader 20180311223345601 for the monthly ticket encouragement)

"Teacher Liu, it's confirmed, AIDP."

Liu Banxia was supervising the interns' consultations when Li Hao came running over.

Ding! Task for patient with unclear respiratory distress symptoms completed

Gained 300 experience points, 20 Glory Points

This task was rated as Flawless, gaining 300 experience points, 5 Glory Points + 20 Glory Points

It's a bit of a pity that it wasn't rated as Perfect, probably because the diagnosis wasn't made independently.

But this is fine, after all, solidifying stone is easy to mix, and Glory Points are quite precious.

The result came out so quickly because the patient's symptoms were quite acute, so the examination was expedited.

"That's pretty good, next up is immunoglobulin and symptomatic treatment, right?" Liu Banxia asked.

Li Hao nodded, "Teacher Peng said the patient's condition is quite good and shouldn't take too much time or cost. Recovery should take about a week, and the prognosis isn't bad either."

"If the diagnosis had been delayed by a few more days, adjustment would have been a lot more difficult. Teacher Peng also said you were very timely and impressive in your detection."

"Tsk tsk, aren't you just flattering yourself?" Liu Banxia teased.

"If you hadn't mentioned it being similar to hypokalemia, I wouldn't have thought about respiratory muscle paralysis. Naturally, I would have just continued observing, waiting to send to ICU, and then waiting for tomorrow's spinal tap."

"Then Doctor Peng would have to ponder for a few more hours to match the patient with the symptoms. It's a bit of a hefty task, isn't it?"

Li Hao grinned, it seemed the Big Boss was in a good mood, becoming a bit chatty again.

At this moment, a young woman clutching her stomach walked in from the main door, in acute abdominal pain and it was quite severe.

It looked almost as if her boyfriend had brought her in.

Liu Banxia glanced at her, "Liu Yiqing, let Li Hao help you suture the patient you're handling, you take this one."

Liu Yiqing glanced over and said a few words to the patient she was managing, then headed towards the woman with acute abdominal pain.

Liu Banxia thought for a moment and decided to follow along to take a look.

It was truly the experience with that acute abdominal pain patient at the city hospital that made him pay extra attention; maybe it was another case?

"You go ahead and help her register, I'll examine her. Where does it hurt?" Liu Yiqing said.

"Right here, it's been hurting all afternoon. The pain started shortly after lunch, thought I could bear with it, but it's been ongoing and unbearable," the patient said.

"Where does it hurt the most, show me," Liu Yiqing said.

The patient pointed to the lower right abdomen, "It hurts a lot, I took Motilium and Gastrocalm, but they didn't work."

"Any other symptoms, like bloating, diarrhea, vomiting, fever?" Liu Yiqing continued to ask.

"None of those, just the pain," the patient said.

"Have you had menstrual cramps before?" Liu Yiqing asked.

"No, I've always been fine, never had any. Doctor, is this appendicitis?" the patient asked.

"Lie down, I'll examine you," Liu Yiqing said.

The patient quickly lay down on the bed, not caring that Liu Banxia was nearby, and lifted her clothes to expose her right abdomen.

Liu Banxia had to help draw the curtain, this is a diagnostic bed, not a consulting room. But this also proves the girl's genuine pain, as she disregarded all that.

"If it hurts, give me a signal," Liu Yiqing said while pressing.

"Yes, right there," the patient said.

Liu Yiqing slightly increased pressure, then tried again twice, suddenly removing her hand.

"Alright, sit up," after the examination, Liu Yiqing said.

"Your examination shows your abdomen is soft, with mild tenderness but no rebound tenderness, the possibility of appendicitis isn't high, it might be acute gastroenteritis."

"Let me ask you another question, have you had sexual intercourse? During the relationship, was contraception used?"

Upon hearing this, the girl felt a bit embarrassed and glanced at Liu Banxia.

"It's alright, he's my teacher," Liu Yiqing reassured.

"Uh... yes, but we did use contraception," the girl said softly.

"I'm asking this to consider the possibility of an ectopic pregnancy," Liu Yiqing said.

"You'll go for an ultrasound later, to check the abdominal organs. Check the appendix, gallbladder, liver, spleen, kidneys, and ovaries."

"Then we'll do a blood test and a urine test. We also need to consider every possibility, even a small oversight."

The patient nodded.

After finishing the examination, Liu Banxia pulled back the curtain and saw the patient's friend walking over, so he waved.

"Doctor, is it appendicitis?" The patient's boyfriend ran over and asked.

"We can't clearly determine that right now. Give me the registration slip, and I'll order some tests for you," Liu Yiqing said.

"The McBurney's point tenderness wasn't strong in the recent examination, and there wasn't any rebound tenderness. It's likely you didn't digest your lunch well, so acute gastroenteritis is more likely."

"She's feeling stomach pain and has difficulty walking. How about you carry her? First, do the blood test, then the ultrasound, and then a urine test. Otherwise, she'll have to hold her urine in for the ultrasound, wasting more time."

"Okay, I'll go pay the fees now." After saying this, the patient's boyfriend dashed off again.

"Your boyfriend treats you pretty well," Liu Yiqing said with a smile.

"He just runs errands. Doctor, do you think going to the bathroom will solve my problem?" the patient asked.

"Let's wait and see the results of the blood, urine, and ultrasound tests. During the examination just now, you seemed a bit warm, though I'm not sure if it was due to pain," Liu Yiqing replied.

The patient nodded, too pained to speak.

Liu Yiqing called over a nurse to take a blood sample first, as she didn't think it was a big issue.

"Teacher Liu, can you analyze the case and see what's going on with the patient?" Liu Yiqing asked after the patient went for her ultrasound.

"What is there to analyze? We'll just look at the ultrasound results," Liu Banxia said with a smile.

"But you did a very thorough job with the consultation, even considering the possibility of an ectopic pregnancy. Some might habitually overlook this, but it's also a cause of acute abdominal pain and shouldn't be ignored."

"We can't afford to be careless; otherwise, we'll get scolded," Liu Yiqing said happily.

"But considering her condition, it's indeed more likely to be acute gastroenteritis," Liu Banxia added.

"We'll just wait for the results. We're having another no-patient day today. Why can't you try to help us achieve our department's breakthrough?"

"Teacher Liu, it's not like we can make it happen just because we want to," Liu Yiqing said helplessly.

"Well, maybe there will be emergency patients tonight. Otherwise, you should work an extra shift and take all the emergency cases," Liu Yiqing suggested.

"No way, I have to go home and see my daughter and son," Liu Banxia said.

"Anyway, there's no rush, so we can take it slow. Our department is still strong, so let's take this rare opportunity to rest," Liu Yiqing concluded.

Today was interesting; there were quite a few patients, but none needed general surgery.

It's a bit unusual as in the past, even emergency surgeries would rack up two or three cases.

"Why are you spacing out?" Shi Lei walked over at this moment.

"No class this afternoon?" Liu Banxia asked.

"Just one, and I came back after it," Shi Lei replied.

"Ah... so relaxed, running back and forth from school to hospital, and earning some cash," Liu Banxia joked.

"Why don't you run around too? Cover a class for me?" Shi Lei suggested.

"No way, not me," Liu Banxia quickly responded.

"I expect to be very busy soon, with no time for unnecessary things. You can take your time with them. When I meet Chief Director Xu for a meal, try to free up your schedule, so we can go together," Liu Banxia said.

"Alright, let me know ahead of time, so I can arrange my schedule. Unlike you, I'm not quick at everything. My patient is here; I need to go see them," Shi Lei said.

Liu Banxia felt a bit helpless.

Even though he's the deputy director, why doesn't anyone register for his consultation, not even an appointment?

After waiting a bit, the patient came back with her girlfriend supporting her.

"Doctor, the B ultrasound doctor said it seems there's no problem, but the appendix isn't very clear," the patient's boyfriend said as he handed over the report.

Liu Yiqing looked at it and noticed the screenshot indeed wasn't very clear, just slightly enlarged.

"The signs for appendicitis aren't clear enough; to really be sure, a CT scan would be required," Liu Yiqing said after putting down the report.

"Or you could choose to observe first; if the pain doesn't worsen, then appendicitis can be ruled out. How are you feeling now? Does it still hurt?"

The patient nodded, "It still hurts, but it's a bit easier than before. Umm... when I left the urine sample, I also had a bowel movement. Could this be related?"

"It's possible. What was the stool like? Soft or watery?" Liu Yiqing asked.

"Uh... not very watery, but somewhat soft," the girl said, a bit shy.

This was a stark contrast to when she was in severe pain, lifting her shirt for Liu Yiqing to examine her.

"In that case, I suggest you observe for now. Acute gastroenteritis is more likely, and doing a CT would just waste money. If the pain becomes severe, there's still time to do it," Liu Yiqing advised.

"Then we'll wait here. CT scans have radiation too, so it's good to avoid them if possible," the patient's boyfriend agreed.

"By the way, doctor, my stool is a bit black; is that okay?" the patient asked.

Upon hearing this, both Liu Yiqing and Liu Banxia's expressions instantly became serious.