Practicing Medical Skills in a Small Clinic-Chapter 82: I Wish I Were Wrong Just Once

The little girl in front of him apparently has a lesion in her leg bones.

At least Li Jingsheng thinks it’s abnormal.

Which diagnostic skill should he upgrade? He’s really having a hard time deciding. 𝗳𝚛𝗲𝕖𝕨𝕖𝗯𝚗𝚘𝕧𝕖𝗹.𝗰𝗼𝕞

He has over three hundred life points, but can’t find the right diagnostic skill to upgrade.

Pulmonary Medicine, Gastroenterology, Hepatobiliary Medicine, Cardiovascular Medicine, all can be ruled out.

That leaves only General Surgery, which barely relates to bones.

General Surgery is known as the origin of surgery; back in the day, it was a jack-of-all-trades.

Over the years, specialization and development have led to separate cardiac, thoracic, neurosurgery, brain surgery, orthopedic, and other departments evolving from General Surgery.

So, General Surgery can actually be called a surgical mix of various specialties.

Li Jingsheng currently knows only five diagnostic skills, and that’s already impressive.

Most doctors only know one or two diagnostic skills.

If one devotes their entire life to deeply studying and understanding the medical diseases and mechanisms of a specific field, that’s the level of a master.

In reality, very few can reach that level.

The sea of knowledge is boundless, even for the most ordinary Pulmonary Medicine; it is enough for someone to spend their whole life learning and researching. And even then, it’s impossible to learn everything.

If Li Jingsheng didn’t have the super cheat of the attribute panel, specializing in so many medical fields at once would definitely be suicidal.

Because countless medical predecessors have proven with bitter lessons that specializing in a specific medical field is best.

For those with exceptional energy and talent, specializing in two fields at the same time is already the limit.

"I’ll have to try to upgrade General Surgery diagnosis to Master Level and see the effect!"

At this moment, he feels that his medical skills are still not enough.

They are too few.

If others knew he already had five diagnostic skills and still said they were too few, they’d probably beat him to death.

One could only say, human desires are insatiable.

General Surgery is a field that his small clinic plans to focus on, and upgrading its proficiency to Master Level is a matter of time.

Now having over three hundred life points, he is feeling quite wealthy.

Having made up his mind, he no longer hesitates, decisively consuming 76 life points, upgrading the General Surgery diagnostic skill proficiency directly from proficient to Master Level, 100.1/500.

The feeling of having ’money’ is really great.

Many dreams that once seemed out of reach can be quickly realized.

Back then, if he managed to upgrade General Surgery to Master Level by the age of sixty, it would be considered a miracle.

Reality might be harsher; his small clinic might not even receive a handful of surgical patients a year, leaving him struggling in the proficient level at sixty.

After General Surgery diagnosis upgraded, he carefully sensed, shocked to discover the diagnostic abilities in surgery increased not just a little, but from a small stream directly to a lake and ocean. Previously, he only knew something about common trauma.

At this moment, he had some understanding and knowledge of numerous General Surgery diseases involving liver, bile ducts, pancreas, gastrointestinal, colorectal, vascular diseases, thyroid, and chest tumors and injuries.

Although the primary focus is on diagnosing the cause, it equally provided insights and help with his pharmacology and surgical skills.

With his increasing Master Level skills, he discovered a certain correlation existing among all medical skills.

They kind of complement each other.

The improvement in General Surgery also somewhat advanced his skills in managing electrolyte balance, infection medication, and emergency quality training.

Automatically checked two pharmacological skills, and their proficiency automatically increased by 10 points.

Pharmacokinetics rose a bit less, automatically gained 5 proficiency points.

The significant rise in proficiency of these two skills was an unexpected bonus.

With Li Jingsheng’s skills improving so much instantly, when diagnosing the little girl again, he finally had a bit of confidence and assurance.

"Mom, my leg hurts, it hurts so much!"

The little girl trembled as she spoke to her mom, and her facial features were faintly distorted.

One could see the bulging cheeks as she clenched her teeth.

"Dr. Li, do you have a way to help? Every time she hurts, my heart feels like it’s being cut."

The child’s mother was so anxious that she almost cried.

"I understand how you feel. It’s very hard for me as a doctor to see your child in such pain. To solve the problem, we must find the cause. My small clinic’s equipment and conditions are limited. It’s actually more advisable for you to take her to a bigger hospital for a checkup."

Based on his professional knowledge and experience, Li Jingsheng believed this little girl’s leg pain is definitely not something as simple as calcium deficiency or rapid growth.

"Please don’t misunderstand, I’m not urging you to go. We are here because we trust you."

The girl’s mother thought that Li Jingsheng was unhappy with being rushed and was telling them to go to a big hospital.

Li Jingsheng has always been very tolerant with patients and their families, and wouldn’t drive people away over minor issues.

"Thank you for your trust. I’ll give it another try. At the very least, finding out what is causing the leg pain is good."

Li Jingsheng again focused on the little girl’s legs.

She was gently massaging her knee and shin with her small hands.

"Did you last take her to the hospital for a checkup three or four months ago?"

"Yes, it’s been almost four months. The pediatric hospital doctor only asked a few simple questions, then said it might be calcium deficiency and told us to buy two bottles of calcium tablets to try."

"Did your child’s knees also appear large when she was younger?"

Li Jingsheng asked again.

"No, it seems to have started over the past year, as her knees gradually grew larger. Perhaps it’s because she’s grown quite fast in the last two years!"

The mother hadn’t paid attention to this at all.

After asking, Li Jingsheng started pondering again.

The family didn’t dare speak this time, silently waiting.

"Little one, let me check you again. Let me know if it hurts a lot."

Seeing the pain in the little girl’s face made Li Jingsheng feel quite distressed.

Pain is humanity’s common enemy.

Every doctor is a sacred warrior against the demons of illness.

Li Jingsheng tried to squeeze her knee, and she immediately groaned in pain.

However, she didn’t speak.

This child is quite sensible.

Enduring the pain and cooperating with the doctor’s examination, she surely hopes that Li Jingsheng can help her find out what’s wrong and relieve her suffering.

"Why does the skin feel a bit hot?"

Li Jingsheng’s first reaction was inflammation.

But he also hadn’t heard of arthritis causing the local skin temperature to rise!

He immediately took an infrared thermometer to measure the skin temperature of the child’s leg.

37.5 degrees.

37.4 degrees.

36.7 degrees.

The temperature difference was significant; the forehead temperature was only about 36.7 degrees, but the temperature in the lower leg and knee area was as high as 37.5 degrees.

The skin temperature of the left leg was also 37.4 degrees.

This is very abnormal.

"Local skin temperature increase, severe bone pain lasting a very long time, pain constantly progressing, knees much larger than those of other children her age, irregular texture on tibia palpation..."

Li Jingsheng connected all the symptoms and the four-month-long medical history for a comprehensive diagnosis.

He exhausted all his knowledge, trying to think of diseases that could cause these symptoms.

Suddenly, he thought of a terrifying disease name.

Bone cancer.

This child’s numerous symptoms looked too much like bone cancer.

And it was very likely that metastasis and spread had occurred, reaching the shoulder area.

Bone cancer in children is relatively rare, usually affecting the bones of the limbs first. Pain is the most common symptom during the prodromal period, particularly joint pain, redness, and swelling with lumps.

Some children also develop varicose veins in the lower limbs.

This little girl has not yet shown signs of varicose veins.

But doctors have ordinary vision, only able to see the superficial veins, not the deep veins of the lower limbs.

"The child’s knee is very large, most likely due to joint enlargement caused by bone cancer. In this situation, the level of pain would be very high, second only to trigeminal neuralgia. At such a young age, I really can’t imagine what great pain she is enduring."

After reaching a preliminary diagnosis, Li Jingsheng’s mood became particularly heavy.

The difficulty of curing bone cancer is extremely high, with a very high recurrence rate.

Moreover, the surgical outcome can be extremely harsh; amputation is considered fortunate if it saves one’s life.

The little girl mentioned recently that her shoulder started hurting too, fearing the cancer cells are starting to invade the arm bones.

"I suggest you take the child to a large hospital for a leg bone examination immediately tomorrow. This disease cannot be treated at my small clinic at all."

Li Jingsheng said in a very low tone.

"Dr. Li, are you..."

The child’s mother still thought they had somehow annoyed the doctor.

Li Jingsheng looked at Tang Ping: "Sister Tang, take the child over there to play for a bit and wash some fruit for her."

Upon hearing this, Tang Ping realized that Li Jingsheng had something to say to the parents that he didn’t want the child to hear.

Once Tang Ping took the child away, Li Jingsheng spoke.

"I examined the child earlier, and the result is not good."

Li Jingsheng said gently.

"Isn’t she just calcium deficient? What’s the actual disease?"

The child’s mother became immediately nervous upon hearing this.

"Initially suspecting a lump."

Li Jingsheng still spoke rather tactfully.

"Wh, what do you mean?"

"It probably means there’s a tumor on the bone. You’d better take the child to a large hospital tomorrow morning for a check-up. The child mentioned her shoulder also began to hurt, and this must be reported to the doctor. If only an examination had been done sooner, I’m afraid we’ve delayed too much already!"

Li Jingsheng said to the family with great distress.

"How... how can this be, how could just a leg pain lead to such a terrible disease, what should we do..."

The child’s mother became weak and could hardly stand.

No longer naive, she now understood that her daughter might have a tumor.

To her, this revelation was like a bolt from the blue.

"Please don’t panic, this is only my preliminary diagnosis, merely an initial suspicion. After going to the hospital for a check tomorrow, we’ll see what can be said then."

Li Jingsheng feared she might faint right there.

Ultimately, the child’s mother, as if lost, took the child and left.

She didn’t even say thank you when she left.

In her heart, the sky had fallen, leaving her no room for anything else.

Li Jingsheng let out a long sigh.

"I really wish I could have misdiagnosed just once!"

He said to himself.

Doctors fear misdiagnosis most; it is even scarier than underdiagnosis.

At this moment, Li Jingsheng intensely hoped his diagnosis was wrong.