Practicing Medical Skills in a Small Clinic-Chapter 40: An Old Man’s Love

Li Jingsheng really wanted to say, a thousand yuan red envelope is not too little, two thousand is not too much, our small clinic doesn’t have many rules. As long as the patient dares to give, I dare to accept.

But after thinking about it, better not.

Saying it would be too low.

If the patient’s illness is cured, and the patient is truly grateful, they will naturally give a big red envelope then.

It’s never been legally prohibited for medical staff to accept red envelopes.

This is a rule put forward by hospitals to enhance medical ethics and prevent doctors and nurses from exploiting patients, specifically as a self-regulating measure. Complaint calls are handled by departments like the hospital’s medical office and disciplinary inspection room.

It must be noted, accepting bribes and patients voluntarily giving red envelopes are two different concepts.

Bribery is illegal.

Receiving gifts from patients is not illegal, but it violates the hospital’s self-regulation rules.

Li Jingsheng is the boss himself, so even if he accepts a red envelope of a hundred thousand, it doesn’t matter.

That’s the benefit of being your own boss.

"Oh, I know, I know!" When the old man got angry, the old lady outside stopped making a sound.

If we’re talking about wisdom, surely men are stronger.

The old man writes Li Jingsheng a blank check to make sure Li Jingsheng takes extra care in treating him.

Also, winning over Li Jingsheng’s goodwill will make the costs more transparent.

The medications prescribed will be good.

With so many benefits, even if he actually gives a red envelope after getting better, it’s worth it.

Spending small money to get big things done refers to giving gifts.

In some less ethical hospitals, if you don’t give the chief surgeon a red envelope, the surgery is handed off to junior, resident doctors, as long as there’s no safety incident, it’s okay. As for the surgical effect, being used as a guinea pig by a group of novices, it’s easy to imagine.

If there are any leftovers, one has to suffer for decades.

If you don’t give the anesthetist a red envelope, you might wake up from pain halfway through the surgery...

These are true incidents that have occurred in certain hospitals with poor ethics.

Patients have to grease palms everywhere for a surgery.

The old man has simple wisdom, whereas his wife seems smart but loses greatly for petty gains, lacking true wisdom.

Li Jingsheng led the old man to the exam room for an ultrasound, revealing the sinus tract to be shorter than expected.

And particularly thin.

Without knowing there was a hidden sinus tract here, even an ultrasound might not detect it.

Then an X-ray was done.

Every time doing an X-ray, he wanted to smash the machine.

The clarity was truly too poor.

After much effort, it finally became clear.

Compared and verified the ultrasound results.

Indeed, the location of the sinus tract found in both tests matched in length.

X-rays pass through tissues’ thickness and density, and are absorbed by tissues, reducing the amount of radiation reaching the fluorescent screen, generating black-and-white contrast through radiation changes.

Clinically, it’s the most affordable and effective for checking fractures.

Ultrasound produces reflecting waves within the body via sound waves, forming images through electronic computer energy conversions afterward.

Its advantage is obtaining sectional organ images, allowing direct observation of organ shapes, prompting objective data like gallbladder, bile duct diameter, wall thickness, and pathology size based on automatic measurement results.

Its disadvantage is difficulty penetrating deeper into bone and air, making it hard to detect air-filled organs like lungs and gastrointestinal, also less effective in adult brain diagnoses. Repeated reflections during imaging can cause false images, even misdiagnosis.

Li Jingsheng uses X-rays and ultrasound simultaneously to avoid misdiagnosis.

Obtain more accurate sinus tract data.

Including its length, width, position, depth, etc.

"Dr. Li, did you find out?"

"Basically yes, it’s a hidden sinus tract causing a superficial back abscess. Without eliminating this sinus tract, the abscess won’t heal and will keep recurring. Also, due to prolonged use of anti-inflammatory drugs, you’ve developed some drug resistance. I recommend immediately dealing with this hidden sinus tract and then perform debridement in the abscess cavity, should cure it completely."

Li Jingsheng told him.

"Can you do it here?"

Clearly still a bit unsure about the small clinic.

"Yes."

Li Jingsheng’s answer was firm.

At times like this, it’s essential to give the patient confidence. If you’re not confident, why would the patient trust you?

"Does it need surgery?"

"Definitely!"

"Is the incision deep?"

"The sinus tract is superficial, and based on my surgical experience and clinical anatomy, I’m sure there’s no major blood vessels or important nerves here, risks are present but very low. Honestly, if it were a major or high-risk surgery, I wouldn’t dare take it either."

Li Jingsheng knew what the patient was worried about.

Nothing but safety.

How to answer to dispel the patient’s concerns, he’s long trained for that.

Don’t assume that surgeries in major hospitals are easy to convince family and patients. 𝐟𝗿𝐞𝚎𝚠𝐞𝚋𝕟𝐨𝚟𝐞𝕝.𝕔𝕠𝚖

They too have various doubts, usually handled by interns and ward doctors to persuade. If the chief surgeon is to handle such trivial matters, they might as well quit.

The chief surgeon is usually at least an associate chief physician, shadow rarely even visible due to busyness.

Only Monday or Friday’s chief rounds may spot them.

Li Jingsheng honed his persuasion when managing the ward. Interns aren’t heavy enough, discussions typically led by ward doctors with families and patients.

Once discussions are mature, then invite the chief surgeon for a formality.

If it’s spinal or general anesthesia, anesthetists also approach families. Primarily to inform them of risks and obtain signatures.

"Does this require staying here for treatment?"

"No need. But post-surgery, your wound mustn’t touch water and requires daily check-ups and dressing changes on time."

From the patient’s questions, Li Jingsheng knew it was basically settled.

"Let me discuss with my wife and get back to you."

The old man stood up and left the exam room.

"Alright."

Li Jingsheng certainly wouldn’t force the patient to do surgery here.

But he really hoped to secure the business.

The old man discussed with the old lady for a good half an hour.

The two of them finally walked together to Li Jingsheng’s consultation desk.

"Dr. Li, we discussed it just now and decided to trust you. Please take care," the old lady said to Li Jingsheng.

"Rest assured, I absolutely wouldn’t joke about a patient’s life safety. The surgery might take more than an hour; once the decision is made, we’ll arrange it right away."

Li Jingsheng had actually prepared for the patient to go to a big hospital.

When it comes to surgery, hardly any patients choose a small clinic; they all head to big hospitals.

This heavy trust was earned by Li Jingsheng through his skills.

First, there was the morning’s wave of publicity; everyone praised his excellent medical skills and noble ethics.

Then this old man heard about it and came to seek treatment with a try-it-and-see mindset.

To his surprise, after some effort, Li Jingsheng managed to diagnose the old man’s condition.

This greatly increased the trust of the old man and his wife in the Sunshine Clinic.

They felt that Li Jingsheng’s medical skills were indeed exceptional.

Li Jingsheng’s conversation with the old man in the examination room just now played a significant role. After weighing things, the old man decided to have the treatment here.

Because Li Jingsheng told him the risks of the surgery were not high.

He also believed Li Jingsheng wouldn’t risk the clinic’s future recklessly.

"It’s decided, let me have it treated here!"

The old man declared confidently.

Men are like that; once decided, they often show great resolve. Women, on the other hand, tend to be much more indecisive.

This is determined by the nature of males and females.

Li Jingsheng looked at Tang Ping.

"Sister Tang, there’s a patient here who needs surgery; are you almost done over there?"

"Okay, I’m almost done."

She was selling medicine to a customer.

Upon hearing Li Jingsheng had taken on a surgery, she couldn’t help but feel pleasantly surprised.

Li Jingsheng began asking the old man if he had any medication allergies, heart disease, etc.

Fortunately, the old man’s health was in pretty good condition and could completely withstand the surgery.

After finishing selling the medicine and seeing the customer off, Tang Ping quickly walked over.

"The old man’s back has a sinus tract, which has been examined with imaging. It’s just superficial; we can operate here. Prepare the surgical kit and local anesthesia. Disinfect in the treatment room and lay out the drapes."

Li Jingsheng instructed her to do the pre-surgery preparations.

Since there’s only one doctor and one nurse in the small clinic, both have to step in for the surgery.

Tang Ping’s face briefly showed a shocked expression, but it quickly disappeared.

Perhaps she hadn’t expected Li Jingsheng to dare take on a real surgery.

But she didn’t say anything, nodded, and went to prepare.

"The surgery costs about 2000 or so; we’ll adjust if needed. Could you prepay 2000 yuan?"

Li Jingsheng wouldn’t perform the surgery first and then collect payment.

Too many deadbeats nowadays.

A small clinic can’t afford it.

"As long as it’s cured, 2000 is fine," the old man was straightforward.

Surprisingly, the old lady didn’t object this time.

She promptly paid the 2000 yuan.

Some old couples truly have money, I must say.

After receiving the payment, Li Jingsheng issued a receipt and then stamped it with the clinic’s finance seal.

"Please rest outside; I’ll take the old man into the treatment room for the surgery. Afterward, during the IV, you can be there to accompany him," Li Jingsheng told the old lady.

"Mm-hmm! Please take care."

The old lady sat on the sofa outside the treatment room. Li Jingsheng even poured her a cup of water.

Tang Ping had to do the pre-surgery preparations now and had no time to attend to the patient’s family.

She brought the old man into the treatment room, having disinfected and laid out the drapes.

"Are you comfortable lying down?"

"Yes."

The old man lay down on the bed in the treatment room.

The small clinic’s conditions were too simple, and they hadn’t performed surgical procedures before. At most, they cleaned wounds, sutured, and bandaged.

Though a small surgery, this was a true surgical procedure.

Li Jingsheng was somewhat nervous, but more excited and expectant.

The skills like skin incision, superficial debridement, multiple suturings, knotting, and hemostasis were all at a proficient level.

Finally, he had an opportunity to practice these skills.

There were certainly risks in performing this surgery; it wasn’t as easy as he told the patient.

The sinus tract was about 2cm deep, considered superficial.

Its length was 7cm, which was quite long.

To remove the tract, the wound would necessarily be longer than the tract.

After initial disinfection of the patient’s back wound, Li Jingsheng prepared to wash his hands, then proceed with sterile management as rigorously as in a large hospital.

The old lady was waving at him from outside the door.

Li Jingsheng went over and opened the door.

Could it be that the old lady was scared of the risks and decided against the surgery for the old man?

"Dr. Li, could you step outside for a moment? I have a few words to say to you."

Li Jingsheng quietly wondered; they were already set to go, please don’t stop at the last minute!

After stepping outside, the old lady pulled him to the side, secretly slipped a wad of cash into his hand.

"A small token, please focus on my old husband’s surgery and ensure his safety."

The cash in hand exceeded a thousand yuan.

A thick stack.

Li Jingsheng was genuinely shocked. Not long ago, in the examination room, the old man casually mentioned giving Li Jingsheng a big red envelope once cured, and the old lady anxiously knocked on the door.

Yet at this moment, before the surgery, she called Li Jingsheng out and secretly gave him a red envelope.

And it was at least a thousand yuan.

She must love her old man deep into her bones to do such a thing!