Practicing Medical Skills in a Small Clinic-Chapter 44: What Did I Do to Deserve This? Harvesting the Most Precious Medical Skill
"It’s probably around here!"
She pointed to that large area on the left side of her upper abdomen.
The location she indicated is exactly where the stomach is situated.
The stomach is about a palm’s distance above the navel on the human body, right on the midline. Most people’s stomachs are positioned slightly to the left in the upper abdominal cavity. 𝗳𝚛𝗲𝕖𝕨𝕖𝗯𝚗𝚘𝕧𝕖𝗹.𝗰𝗼𝕞
Food enters from the mouth and, after being chewed, passes through the pharynx and is swallowed, then travels down the esophagus into the stomach for storage.
So, if you feel bloated after eating, it’s often because you’ve overeaten and the stomach is too full.
This is what causes mild discomfort in the body.
"How long after eating do you feel bloated?"
"Sometimes I feel somewhat bloated halfway through a meal, but most times I feel my stomach bloating a few minutes after finishing eating."
"Do you experience reflux? Like acidic fluid flowing back from the stomach to the mouth or pharynx."
"Occasionally. It’s especially severe at night while sleeping and during the period after waking up in the morning."
Listening to her, Li Jingsheng’s expression gradually became serious.
"Do you burp or have belching after meals?"
"Rarely."
She thought for a moment before answering.
"Doctor, is there anything serious with me?"
This woman is quite perceptive; from Li Jingsheng’s increasingly serious expression, she seemed to sense that her problem might be significant.
It made her very frightened.
Wealthier people fear death more than poor people do.
Because wealthy people usually live comfortably, and with significant wealth in hand, they can afford treatment if they get sick.
Poor people fall ill and hardly dare to visit a hospital.
The idea that the poor have cheap lives was true in ancient times and remains true in modern times.
"Have you had an examination at a big hospital?"
"No."
"Then I suggest you go to the hospital for a stomach check, preferably get an X-ray."
"What illness do I have?"
The woman’s face slightly turned pale; maybe she had never considered that just feeling a bit overstuffed could be a major illness.
What do wealthy people fear most?
Cancer.
This disease doesn’t differentiate between rich and poor. Many types of cancer, once discovered, are already in the mid to late stages, and no amount of money can cure it.
That’s why wealthy people fear cancer the most.
A young man with a center-parted hairstyle, reasonably handsome, pushed open the glass door of the clinic and leaned half of his body inside.
"Sister Huan, did you buy the digestive tablets?"
The ’lady of wealth’ glanced back at the man.
"The doctor suspects my condition is severe and suggests I go to a big hospital for a check-up."
You could tell that when she said this, she was really longing for some comfort from this young man.
The man was dressed in a dark red suit, wore a gold tie, and his shoes were polished to a shine, enough to be used as a mirror.
He walked with both hands in his pockets, his body slightly swaying.
Giving off an air of frivolity.
Li Jingsheng, using his social experience, had the first impression of this man as ’gigolo.’
The ’lady of wealth’ was at least forty-seven or eight years old, likely because of good maintenance and a well-off lifestyle, appeared much younger than her actual age. She could very well be over fifty.
A woman’s age and the number of boyfriends she has are the hardest to guess.
Older wealthy women, some in their sixties, can still look like young women in their thirties. With fair and firm skin, they maintain an excellent figure. Add makeup and attire, and outsiders can hardly discern their true age.
"Sister Huan has always been in good health and surely won’t have any issues. Many doctors at small clinics deliberately scare people, aiming to trick them into buying medicine to make money, so let’s not buy anything here."
The young man naturally half-hugged the ’lady of wealth’s’ shoulder upon entering.
Without knowing the facts, he labeled Li Jingsheng directly as a black-hearted, scammer doctor.
Moreover, he said this openly, right in front of Li Jingsheng.
"Oh dear, young man, you can’t talk like that! Dr. Li is not only medically skilled but also highly ethical, he won’t even accept the red envelopes I offered him!" The elderly lady accompanying the old man in the infusion room heard someone slandering Li Jingsheng and promptly came out to defend him.
Help comes to those who have moral principles, while those lacking them get little assistance.
Li Jingsheng’s noble medical ethics had already won over both the elderly man and woman. Upon hearing someone slandering Li Jingsheng for potentially scheming for money, she stood up voluntarily to speak on his behalf.
"Nowadays, small clinic black doctors are really cunning, they use various tricks to gain customers’ trust and then fleece you without hesitation. You elderly folks are most susceptible, so be careful, and don’t buy any health products they urge you to purchase."
The young man wouldn’t listen to any advice.
Having preconceived an impression that Li Jingsheng was a clinic scam doctor, no one could get through to him.
Li Jingsheng was speechless.
What’s going on today? This young man came in immediately to berate him.
To make this young man so hostile toward clinic doctors, he or his relatives have likely been swindled by such doctors before.
Every industry has its bad apples.
The reputation of clinic doctors isn’t great; it’s synonymous with poor medical skills, malign natures, shrewdness, and money-driven tactics.
"Xiaogao, this Dr. Li doesn’t seem like a bad person; he didn’t ask me to buy any medicine just now, rather advised me to get a check-up at a big hospital."
The lady of wealth wasn’t senseless in her fancy attire after all.
She could still distinguish right from wrong.
"Sister Huan, you don’t understand these people’s tactics. They gain your trust first, then slowly take advantage of you. My mom was killed by a doctor from a shady clinic. Let’s go. If you want to get checked at a big hospital, I’ll accompany you."
The young man clearly didn’t have the decision-making power.
In every aspect, the wealthy woman took the lead.
"Dr. Li, I’m sorry! I’ll go to a big hospital for a check-up first. If I need anything in the future, I’ll come to you."
The wealthy woman stood up and apologized to Li Jingsheng.
Then, hand in hand with the young man, she left the clinic.
It was evident that she was feeling a bit heavy-hearted.
"Make sure you go to a big hospital for an examination, don’t delay. It’s best if there’s nothing wrong, so you’ll be at ease then." Li Jingsheng was worried that the ’gigolo’ might whisper in her ear again, causing her to give up on getting checked at the hospital.
If there’s a serious illness by then, it would be too unfortunate.
Stomach cancer often starts with bloating and stomach pain.
"Okay, thank you, I’ll go now."
As she spoke, the wealthy woman took out car keys from her bag and threw them to the young man.
"Drive to the nearest Second Hospital."
"You really believe the nonsense from this small clinic doctor?"
"Stop the nonsense, Dr. Li said it’s best if there’s no illness, so you can have peace of mind. Go bring the car over."
The wealthy woman reprimanded him somewhat unhappily.
"Haha, why are you mad? Women shouldn’t get mad, it makes them age faster. I like seeing you happy every day. I’ll go with you, I’ll go with you right away!"
The young man flattered the wealthy woman in every way possible.
He spoke such mushy words openly in front of others, appearing extremely natural.
He’s a professional at this; this is his job.
The wealthy woman was coaxed by him and stopped being upset.
"Once the check-up is done and if my health is okay, I’ll take you to buy some nice clothes." She promptly offered some incentives.
Li Jingsheng shook his head; the world is so big, with all kinds of people and lifestyles.
Everyone has their way of living.
Making a living with one’s looks is a skill too.
...
The elderly man finished his infusion and was observed for another half hour. His body was fine, everything normal.
Only then did Li Jingsheng give some dietary advice and let the loving elderly couple leave the clinic.
The small clinic temporarily returned to being quiet.
He sat behind the counter, eagerly counting the rewards from performing surgery on the elderly man.
His experience level had reached Resident Physician level 368.5/500.
The last time he checked, it was 317.5, now it’s increased by 51 points.
If he guessed correctly, diagnosing and operating on the elderly man increased the experience by 50 points. The remaining 1 point should be from diagnosing the wealthy woman just now.
During this time, he had only seen these two patients.
Gastroenterology proficiency 12.7/100.
Increased by 0.5 proficiency points.
This was earned from diagnosing the wealthy woman.
General Surgery proficiency 20.1/100.
Amazing, this diagnosis skills have increased by 10 proficiency points, which is quite surprising.
The elderly man’s abscess formation cause diagnosis was quite difficult and very concealed; none of the surgeons at the community health service station could diagnose it. Li Jingsheng found out the cause, and gaining 10 proficiency points is well-deserved.
For Li Jingsheng himself, the growth gained from this diagnosis goes far beyond just obtaining diagnosing experience.
Next time he encounters difficult cases in General Surgery, he’ll know how to start, think multidirectionally, and consider unseen factors in comprehensive analysis.
These practical progresses can’t be learned from books, teaching videos, or lectures.
The difference between someone who has swum successfully once and someone who has never swum is significant.
Pharmacology proficiency 19.3/100, Pharmacokinetics proficiency 16.9/100.
His medical skills in formulas have increased by 1.1 and 1 proficiency points respectively.
Sold so many drugs, and prescribing for the elderly man was a real brain teaser, so gaining this proficiency in medical formulas might seem small, but already counts as good growth.
Because the improvement in these two medical skills is extremely difficult and slow.
If prescription skills improved easily, hospital chief physicians wouldn’t have white hair by fifty or even become bald.
Often, prescribing for patients requires considering various aspects.
If the effect is unsatisfactory, it requires even more thought.
Li Jingsheng then checked the most anticipated surgical skills.
Horizontal mattress suture gained 1 proficiency point, surgical knot and square knot gained 0.2 each, pressure hemostasis gained 0.1, superficial wound debridement gained 1 point, skin incision gained 1 point.
The substantial growth made him very satisfied.
At the end, a new medical skill had appeared, which was what he anticipated the most.
Sharp traditional scalpel dissection beginner 2/10.
Looking at this newly acquired surgical skill filled him with a sense of accomplishment.
Finally, there’s the first dissection technique, and it’s the sharp traditional scalpel method. Heard that mastering this medical skill means having a tactile feedback ’Roman Road.’
From now on, when performing minor surgeries needing dissection, he can deal with it smoothly.
Taking some risks at the time and bravely attempting to separate the patient’s sinus, was really worth the valuable return.
As for the proficiency in the dissection method, directly increasing from 0 to 2, this surprise compared to the medical skill itself, is now trivial.
