The Enhanced Doctor-Chapter 399: Finding a needle in a haystack

"What the fuck are you telling me? Didn’t you just say surgery was too risky and couldn’t be performed at all? Why the fuck can it be done now?"

After Liu Banxia and the others explained the situation to the patient’s parents, the patient’s father erupted.

"Please stay calm, I..."

"Su Wenhao, let me explain." Liu Banxia patted Su Wenhao’s shoulder.

"During our recent examination, we didn’t discover a large tumor in your child’s lungs. The complications from gallstone pancreatitis, which was the first condition we diagnosed, have affected the tumor, leading to acute pericarditis."

"Acute pericarditis has already impacted your son’s breathing. Right now, ensuring his airway is clear is our first priority."

"What the hell have you been doing all this time? What have you checked? Wouldn’t you know to check if my son hadn’t gotten sick?" The patient’s father was still very agitated.

"We performed multiple auscultations when your son was admitted, and the sounds from his lungs and heart were completely normal. If you believe there’s an issue with our consultation, you can file a complaint with our hospital’s medical affairs department or the medical dispute resolution committee," Liu Banxia said calmly.

"But the most urgent matter now is your son. We’re currently performing drainage, which can only provide temporary relief. Once the volume of the effusion exceeds the amount drained, it will again threaten his life."

"Is my son’s tumor cancer? Lung cancer?" The patient’s father finally calmed down a little.

"Although we haven’t performed a pathological test yet, we suspect it’s non-small cell lung cancer. It’s highly malignant, and the five-year prognosis isn’t very good," Liu Banxia said.

"I just discussed this with the cardiothoracic surgeon. Currently, there are two ways we can address the problem. The first is the surgical removal of the tumor, as Dr. Su recommended. The gallbladder can also be removed at the same time."

"The second option, which he didn’t have time to mention, is conservative treatment using chemotherapy. However, for such a large tumor, it would require at least four courses to see visible effects, and this number might increase due to the pancreatitis."

"Furthermore, throughout the chemotherapy period, your child would still be at risk of pericardial effusion and require constant observation. The chemotherapy process itself will also be painful. Therefore, we recommend surgical treatment."

"These are the only two options currently available. We can give you about an hour to consider. Any longer, and the risk to your child will increase; it might be too late."

"Doctor, thank you. We’ll think about it," the patient’s mother said.

Liu Banxia nodded and pulled Su Wenhao aside.

"Teacher Liu, I..."

Liu Banxia waved his hand. "We want you to communicate more with patients’ families so you can get used to it. Not all relatives can remain calm and restrained when they hear a diagnosis."

"They are people without medical knowledge. They wish doctors could diagnose all diseases with a single glance upon arrival at the hospital."

"Communicating with patients’ families is also a very important part of our work. If they cooperate, it gives us more time."

"But also remember, don’t indulge those who make unreasonable trouble. Like those medical troublemakers I’ve encountered before, don’t give them an inch."

"Thank you, Teacher Liu," Su Wenhao said earnestly.

"What’s there to thank me for? You’re just overly concerned about the patient and too anxious. It’s fine now. Just stay by the family’s side and speak less," Liu Banxia said with a smile.

Su Wenhao nodded and quickly went over.

"The patient’s family hasn’t made a decision yet? Then I’ll get back to my work. The temperature has dropped these past two days, and we have more patients," Chen Xuehai said as he walked over.

"I gave them an hour. I estimate they’ll have a decision within half an hour," Liu Banxia said.

"I agree with you; surgery is the preferable choice. That tumor is indeed too large, and chemotherapy would take too long. The patient would suffer a great deal."

He was actually a little anxious. There was still that patient in the ICU; he had also been involved in that patient’s admission and was worried about them.

But this patient was his direct responsibility. He had to see it through, at least until the family made a choice and the medical orders were issued.

"Teacher Liu, what were you just teaching Su Wenhao?" Liu Yiqing chimed in, approaching them.

"I was imparting my unique technique. Lately, I’ve been focusing on your technical skills and have neglected training your communication with patients’ families. We need to make up for that," Liu Banxia said.

Hearing this, Liu Yiqing’s face fell.

Not every illness can be cured upon arrival at the hospital. Whether patients are brought in by ambulance or come voluntarily, there’s always a chance of losing them.

"Don’t look at me like that. If we don’t strengthen this aspect of your training, how will you be able to work independently in the future?" Liu Banxia said with a smile.

"Inform everyone so they can be mentally prepared. Communication with patients’ families will now be an important parameter, affecting your future opportunities to lead surgeries."

Looking at Liu Banxia’s smiling face, Liu Yiqing felt very frustrated.

You have to listen to Teacher Liu, or he’ll really make things difficult for you. Remember how he tormented everyone during their first chance to be lead surgeon?

Now that he’s said this, it means in the near future, you might miss out on your beloved surgeries. Because the ’dear’ Teacher Liu understands everyone so well; the more you want a particular surgery, the more he’ll find fault with you.

"Teacher Liu, the patient’s family has agreed! We can do the surgery!" After a little more waiting, Su Wenhao came running back excitedly.

"Did you explain the potential complications to the family?" Liu Banxia asked.

Su Wenhao nodded vigorously. "Yes, I explained everything. I got the information from the cardiac surgery department."

"Good. Prepare the patient for surgery. I’ll arrange the OR and have Dr. Chen from Cardiac Surgery perform the operation himself. Any issues with the gallbladder removal?" Liu Banxia continued.

Su Wenhao nodded again. "No problem."

"Alright. You go ahead and get started. I’ll come to the OR later to supervise," Liu Banxia said with a smile.

Su Wenhao scurried off. Liu Banxia then waved at Wang Huan in the internal medicine consultation room.

"You go on ahead! I still have three patients here. I’ll find you as soon as I’m done!" Wang Huan called out.

Liu Banxia didn’t hesitate and headed straight for the ICU in the Emergency Center.

"President Liu, are you here to see the patient with the high fever?" Su Hongbo, the attending physician in the ICU, asked.

"Yes, I got held up downstairs. How’s the situation?" Liu Banxia nodded.

"We’ve issued a critical condition notice; it’s heart failure. And based on current vital signs, multiple organ failure might follow," Su Hongbo said.

"We’ve already put the patient on a ventilator and started anti-infection and anti-heart failure treatments. If there’s no improvement after observing for a bit longer, I was planning to call you for a multidisciplinary consultation."

"The current symptoms are very complex. Although we’ve contacted the patient’s family, they haven’t provided any useful information. It’s just as Doctor Wang recorded at admission: they all thought it was a common cold and didn’t pay much attention."

"The anti-infective drug we’re currently using is a broad-spectrum antibiotic. If we can’t pinpoint the actual source of the inflammation, subsequent treatment will be very difficult."

Liu Banxia furrowed his brow and began reviewing the patient’s follow-up examination results on a nearby computer.

A chest and abdominal MRI had been done, showing no tumors. The head CT results were also normal, with no issues detected.

The blood culture results weren’t back yet. That takes time, and this patient might not be able to wait that long.

"Dr. Su, the patient’s temperature has risen another degree!" a nurse exclaimed, rushing over.

"Get an ice blanket! Physical Cooling!" Su Hongbo ordered.

"Chen Xuehai from Cardiac Surgery is heading into an operation soon, and Wu Xiaoyue is also in surgery. Once Wang Huan finishes his consultations and can come up, I’ll call a cardiologist. Then we can all discuss this," Liu Banxia said after a moment’s thought.

"If the condition continues to deteriorate, I’ll call for help from the inpatient department. We can’t just let this patient decline without understanding why."

"Based on the current symptoms, I personally believe it’s a heart-related condition," Su Hongbo said.

"But we’ve already done an echocardiogram, and it showed nothing. We also confirmed with the family that the patient has no history of heart disease."

This case is complicated, Liu Banxia thought. Usually, patients with heart conditions have a prior history. Now, finding the cause is like looking for a needle in a haystack.

Xu Guosheng from Cardiology and Wang Huan arrived together. By then, the patient had already developed jaundice, indicating impaired liver function; the liver was also failing.

"I agree with Dr. Su’s assessment. It’s the heart and liver now; next, it could be the kidneys or lungs," Xu Guosheng said.

"The challenge now is finding the cause. Considering how long the patient has been ill, the deterioration is accelerating. I estimate that by dinnertime, it could progress to multiple organ failure," Wang Huan said.

"By then, even if we identify the cause, I’m afraid we might not have enough time to save him. President Liu, try to recall carefully if we overlooked anything during admission."

Liu Banxia shook his head with a wry smile. "If it weren’t for your sharp observation, we might have discharged this patient. Now, all we can do is continue with cooling, anti-infection measures, and immune support, right?"

Su Hongbo nodded. "Without identifying the true cause, we daren’t administer drugs recklessly. Doing so could accelerate the patient’s organ failure."

A heavy mood settled over everyone. With enough time, they were confident they could find the cause, but time was precisely what they lacked.