Practicing Medical Skills in a Small Clinic-Chapter 66: Dangerous Diarrhea

Doctor’s Level: Senior Resident Physician 553/1000.

Comfortable, directly increased by 52.1 experience points.

Under normal circumstances, handling ordinary cases increases very few experience points, diagnosing a common cold patient only adds 0.1 experience points.

A slightly more difficult case can increase more than 1 point.

Increasing so much at once, as expected, is definitely because he successfully diagnosed a tuberculosis case that even major hospitals misdiagnosed.

Tuberculosis and early-stage lung cancer are highly similar in both symptoms and imaging results.

Sometimes even the sputum smear results can be negative.

This makes misdiagnosis more likely.

For him, a doctor in a small clinic, to successfully correct this misdiagnosis under simple conditions is truly challenging.

The gains from this are also substantial.

Especially in the comprehensive application of medical knowledge in clinical practice, and connecting similar symptoms through family members for diagnosis, this was the first time.

Overturning the diagnosis from major hospitals was also a first.

Daring to challenge authority, to deny the diagnosis results of authoritative doctors, requires immense courage and insight for this small clinic doctor.

This kind of leap in growth, adding 50 points of level experience, is truly not too much at all.

Pulmonary Medicine Mastery 111.9/500.

Pulmonary diagnosis proficiency increased by 11 points.

If guessing correctly, one point comes from several patients with colds and coughs, and the other 10 proficiency points come from successfully diagnosing two tuberculosis patients.

Life Points: 257.

Increasing by 107 points, with 7 points from ordinary patients.

The sudden increase of 100 points comes from the elderly with tuberculosis.

Seeing life points being used more and more, he can’t help but sigh, spending life points to improve doctor’s level and medical skills is the real deal.

If he was still at his previous mediocre level, neither the old lady with the heart problem, nor the old man with a boil on his back, or Ms. Ou with acute bronchitis from pollen allergies, or the father and daughter with tuberculosis, could be diagnosed or treated.

Thus, he realizes that only by continually spending life points to improve medical skill levels can he possibly earn back more life points.

Spending doesn’t mean spending recklessly.

But rather saving for critical moments, spending life points on the ’blade’.

Whether surgical skills or orthopedic skills, many require access to the operating room or outpatient clinic at major hospitals to learn.

Reading books, watching teaching videos, buying tools to practice - it’s difficult to enter the field this way.

"I’m running a clinic here, and I don’t have the opportunity to work at a major hospital! First, I need to handle the rent hurdle; once there’s some money in hand, finding an orthopedic doctor for private learning might be a good idea."

However, the best way is still to follow an old doctor to the outpatient clinic, to the operating room to learn.

For example, manual shoulder joint reduction.

You need to watch the senior doctor’s operation, detailed explanation of the manual reduction techniques, and hands-on practice to possibly rapidly learn.

Just listening to the teacher’s explanation to try to entry-level, very difficult.

Guided, hands-on teaching, that is the most ideal.

At this moment, a young man holding a bag in his left hand and a newspaper in his right hand poked his head in.

Glancing around, he found only Li Jingsheng alone in the clinic.

Possibly feeling a bit deserted, he prepared to leave.

"May I ask who you’re looking for? Is there anything you need?"

Li Jingsheng noticed him.

The man was wearing dark gray trousers, with shoes covered in dust, a striped shirt, and a deep red tie on his upper body.

Wearing glasses, his figure slightly skinny.

Judging from his attire, he should be a programmer or a salesperson.

"I saw the report about your clinic in the Urban Daily, and just happen to have a bit of diarrhea lately, so I wanted to ask if there’s any anti-diarrheal medicine here?"

The man walked in.

As soon as he approached, Li Jingsheng smelled a sour odor.

Possibly caused by sweating all day.

However, this sour smell was quite strong, possibly because he hasn’t showered for two days after sweating.

In internet cafes, you can often smell this pungent odor.

Some ’experts’ for gaming, soaking in internet cafes day and night, don’t go home, don’t shower, eventually their bodies stink.

"I do have anti-diarrheal medicine here, but it needs to be tailored to your symptoms. How long have you had diarrhea?"

"It’s been three to four days! Recently the project deadlines are tight, basically only going home once every two days. Stayed up Monday night writing code, and the next day started having diarrhea. I thought I’d get better, but instead, it’s getting worse. Now the stomach feels a bit painful, on and off, and I keep wanting to use the bathroom."

The man indeed seemed to be a programmer.

Jiangli City has a high-tech development zone, about half an hour’s drive from here.

Many young people working in the high-tech development zone rent houses in the Old Street of South City to save on rent. Rent is cheap here, living costs are low, and there’s a plethora of local snacks available.

The best part is the atmosphere.

It attracts a large number of young workers to rent and live here.

They scatter during the day and return to live at night.

Some lucky ones save enough and eventually buy houses in the high-tech development zone.

Once the lucky ones who buy houses move out, more young people in their twenties who just graduated from school move in, and so the cycle continues.

Those who can successfully buy houses through hard work eventually take root in this city, merging into it.

Those who can’t earn enough, facing no hope after their thirties, either go back home or move to other cities.

Programmer income is considered quite high.

The minimum is seven to eight thousand/month.

This young man, around twenty-eight or twenty-nine, is likely trying to rewrite his destiny through hard work, aiming to own a house in this city.

Reality is very cruel, without a house, it’s hard to get married.

Men are fighting hard to find a wife.

"Come over here, let me take your temperature and blood pressure."

Li Jingsheng could empathize with the challenges faced by this young man.

The best way he could help was to eliminate any risks as much as possible and prescribe the most suitable anti-diarrheal medicine.

"Do I need to have my blood pressure and temperature taken just to buy anti-diarrheal medicine?"

"Don’t worry, this is part of a free consultation project, no charge."

Li Jingsheng understood what the young man was concerned about.

Even though a programmer could make ten or twenty thousand a month, or even more, they were basically risking their lives to earn it.

The money they earn is hard-earned.

Many programmers jokingly call themselves ’brick movers,’ code monkeys.

And they are quite frugal with their spending.

Because they want to save money for big things.

Buying a house, buying a car, getting married—all of these require a lot of money.

"No wonder even the Urban Daily praises you here for having such high medical ethics! The experience is indeed very nice."

This time, the man did not refuse and cooperatively sat down next to the examination table.

Li Jingsheng took his temperature—it was normal at 36.7 degrees.

He also measured the blood pressure, which was relatively normal.

Out of caution, he checked the man’s pulse. It was fast.

beats per minute.

This meant the patient’s heart rate was likely also 120 beats per minute.

Li Jingsheng’s once-relaxed expression suddenly became tense.

The heart rate doesn’t speed up without reason.

Diarrhea itself isn’t a major issue, it’s quite common.

Usually, it can resolve on its own without medication.

The duration generally isn’t long—some can self-recover in two to three days. More stubborn cases might take about half a month.

If diarrhea is severe and lasts more than three days, it needs medical attention, as it can cause dehydration, electrolyte imbalance, poor nutrient absorption, and other problems.

There is also a type called chronic diarrhea, which isn’t severe but recurs.

If it lasts more than three weeks, one should go to the hospital for a check-up.

"Is the diarrhea very serious?"

"A bit serious, especially this afternoon—I felt as if I was going to collapse."

The young man replied.

"Is there any chest pain?"

"It seems a bit painful, but I can’t distinguish whether it’s stomach pain or chest pain. Because when the stomach hurts, it feels like the chest hurts a bit too."

Some pains can radiate to other parts.

For instance, upper abdominal pain can sometimes radiate to the back, or even the shoulders.

This requires doctors to carefully distinguish with professional knowledge.

"Let me listen to your heart sounds; your heart rate seems a bit fast."

Li Jingsheng indicated for the man to unbutton two buttons of his shirt.

"Is this serious?"

The man asked nervously.

"I can’t answer you just yet; once I finish the diagnosis, I’ll provide you with a more accurate recommendation."

After saying this, Li Jingsheng began to listen carefully to the man’s heart sounds.

"Thump... hiss! Thump... hiss!"

He heard a significant heart murmur in the patient.

There was definitely a problem.

As for whether it was serious, to be honest, his cardiovascular Medicine diagnostic skills were rather basic.

He’s still at the entry level and couldn’t make a diagnosis.

He couldn’t treat heart diseases at this clinic anyway.

Li Jingsheng was contemplating whether to upgrade his cardiovascular Medicine diagnostic skills by one level for this young man.

He was always reluctant to spend his precious life points to upgrade this skill because, even if he could diagnose cardiovascular diseases, his small clinic couldn’t handle them.

In the end, he could only advise the patient to go to a larger hospital for treatment.

With just over two months left to pay the rent, and still owing Tang Ping’s salary, he dared not waste life points on medical skills that couldn’t generate revenue.

If it were for upgrading surgical suturing skills, he wouldn’t even bat an eye.

"Excuse me, are you the Dr. Li mentioned in the newspaper?"

The young man couldn’t help asking when he saw Li Jingsheng deep in thought.

"Yes, my surname is Li."

"Dr. Li, I think it’s probably nothing serious; maybe it was just staying up late for overtime and eating unhygienic snacks that caused the diarrhea. You can just prescribe me some anti-diarrheal meds and I’ll take them at home to see how it works. If it doesn’t get better by tomorrow, I’ll go to the hospital for a checkup."

The young man said.

If it were just a minor headache or cold, Li Jingsheng would certainly agree.

Diarrhea, accompanied by a rapid heart rate and heart murmurs, made him very worried.

Some heart conditions progress quickly, and if the treatment window is missed, a vibrant life could be lost!

This patient is only around twenty-eight or twenty-nine, and his parents had worked hard to support his college education. Should anything happen to him, how would his family cope?

"Don’t worry, let me diagnose further. It’s not the diarrhea that’s worrying—it’s the possibility of a heart issue, especially since you’re living alone, which is extremely dangerous. Give me a bit more time to piece together your medical history and symptoms."

Li Jingsheng couldn’t even conduct a basic blood test here, and could only rely on his experience and knowledge to make an educated guess.

Perhaps 10 life points could save a young life; if spent, then so be it.

After a slight hesitation, Li Jingsheng decided on the spot to spend 10 life points to upgrade his cardiovascular Medicine diagnostic skills to proficient level.