Practicing Medical Skills in a Small Clinic-Chapter 294 - 165: Overturning Everything—It’s Always Good to Know More Medical Skills
The patient’s bone marrow analysis indicates increased activity, with particularly active erythroid hyperplasia.
Approximately 0.64.
The predominant cells are intermediate and late-stage erythroblasts. The mature erythrocytes vary in size and are helmet-shaped, with fragmented erythrocytes comprising 0.07.
It’s well known that bone marrow has hematopoietic functions.
Young erythroblasts can be considered ’children’.
Combining the bone marrow analysis with the complete blood count, Li Jingsheng found that this female patient had significant symptoms of hemolysis.
As for central nervous system lesions, he believed the possibility was relatively low.
Director Mu’s initial diagnosis for the patient was central nervous system infection? Septicemia?
Could septicemia cause hemolysis?
Septicemia can cause multi-system dysfunction in the body; indeed, severe infections can cause coagulation abnormalities.
However, the patient’s test data and overall presentation don’t seem to align with septicemia.
"Dr. Li, do you have any diagnostic direction?"
Director Mu did not dare to have high expectations.
Providing even a little helpful diagnostic direction would be good.
"I... I don’t dare to say!"
Li Jingsheng hesitated, as if he wanted to speak but held back.
"There’s nothing to be afraid of. I won’t blame you if you’re wrong. Go ahead, speak freely."
Director Mu encouraged him.
It was clear that Director Mu still thought Li Jingsheng was having difficulty with the diagnosis due to a lack of knowledge and worried about saying the wrong thing.
"Then I’ll speak freely. I believe there’s a possibility of the patient’s central nervous system being infected, but it’s very small. As for septicemia, I think it can almost be completely ruled out."
Li Jingsheng was concerned that the older doctor might not accept it, so he spoke very tactfully.
Director Mu was silent for a while after hearing this.
After a good ten seconds, he finally spoke, his face somewhat stiff, "You’re saying both initial diagnostic directions can be ruled out?"
This was the result of a discussion among Director Mu and several doctors in the department.
They had even consulted a neurologist over the phone for the discussion.
Yet this small clinic doctor came in and dismissed both initial diagnostic opinions.
"It should be possible to rule them out."
Li Jingsheng was quite worried that this renowned pulmonologist might just collapse.
Luckily, Director Mu was more resilient than he suspected.
He saw Director Mu take a stainless steel thermos and take two large gulps.
"Have some tea. You should drink tea too. Then tell us about your diagnostic direction. You’ve dismissed both of the initial diagnostic results we discussed. Impressive."
Clearly, Director Mu was not convinced.
But he also had a hint of anticipation.
He wasn’t sure if this young clinic doctor was just being reckless or if he really possessed considerable skill.
Li Jingsheng’s current diagnostic abilities focused mainly on three areas: pulmonary medicine, gastroenterology, and general surgery.
He wasn’t particularly good with neurological diseases.
However, because of his clinic, he frequently encountered some dermatology patients.
Diagnosing such patients often required knowledge of immunology. So he had studied immunology, particularly dermatological immunology, quite extensively.
He regularly read books in this area to keep up-to-date.
He took a sip from his teacup. It tasted slightly astringent at first, but then an aromatic flavor filled his mouth, and his mind felt refreshed.
"Good tea!"
He couldn’t help but praise it.
To put it in simple terms, he had never had such good tea before.
"Hehe, this tea was given to me by a student of mine. He’s now in a major institute in the magic city; I heard he got promoted to a group leader, with a pretty decent income. A few days ago, he sent me a small box of tea. I even joked at the time, saying this little bit of tea would only last a few brews."
The implication was that the student was a bit stingy.
However, Director Mu’s face clearly showed pride.
After all, everyone likes to show off something they consider proud or impressive sometimes.
"Later, a vice president came to me for something, and I brewed some tea for him with those leaves. He recognized at once it was high-grade Da Hong Pao, and said these would have been used by the royal family in ancient times, very limited in production. Even if you had money, it’d be hard to buy, due to its scarcity. I later asked someone to inquire about the price, and this little box cost over seventy thousand. My heavens, that’s like my salary for two months."
Unintentionally, Director Mu disclosed his income level.
He was a chief physician in pulmonary medicine, earning about thirty-five thousand, lower than expected.
Li Jingsheng thought someone at his level would earn at least fifty thousand a month.
Some doctors valued their reputation, adhered to laws and regulations, and did not like earning that extra income, which obviously affected income levels.
Moreover, the real money-makers were top surgeons.
Internal medicine was lucrative too, but it couldn’t compare with top surgeons.
The top team leads in surgical departments in the country can earn over five million a year steadily. For internal medicine, even with lectures and industry-sponsored academic exchanges, two million a year is the ceiling.
"How much did that cup of tea cost? I should finish it; otherwise, it’d be wasteful."
Li Jingsheng never expected Director Mu to serve him such expensive tea.
While it might sound exaggerated, he genuinely appreciated it.
"Haha, if you like it, I’ll give you some later." Director Mu laughed heartily.
However, with the patient’s issue unresolved, after the laughter, his brows still showed concern.
"Your student gave it to you. It’s already a privilege for me to have a cup. Asking for more would be greedy. Besides headache, fever, and aphasia, are there any other symptoms in that patient?"
