The Enhanced Doctor-Chapter 400 draw silk from cocoons

(Thanks to my good friends Xin Xian, Feng Lan Qi Yi, Wei Pao Pao, 1111 Xiang, The Champion, Hou, and Pirate Flag Xinuo for encouraging me with their votes.)

"You all go ahead and get busy. I’m going in to observe the patient some more," Liu Banxia said after a moment of silence.

"If there’s a patient downstairs who needs emergency care, call for me. Also, let me know the results for the lung tumor removal patient when they come out."

"Alright, President Liu, activate your brain. I really can’t figure it out," Wang Huan said with a bitter smile.

"Don’t worry, I’ll stay here with Dr. Su and keep an eye on things," Liu Banxia said.

Every doctor who has been in the profession long enough will experience this feeling: if a patient’s illness is diagnosed and has reached an incurable stage, their feelings might not be so complex.

Now, they knew the patient was not going to make it, but they couldn’t even identify the cause of the illness. That feeling of helplessness was truly suffocating.

After preparing himself, Liu Banxia walked into the ICU. This wasn’t his first time entering this special ward, but he still felt a bit resistant.

After all, those who stayed here were not ordinary patients; even those with the mildest conditions had undergone major surgery and needed observation here. Even the car accident patient he had saved that night had already been transferred to a general ward.

"President Liu, you should really pay more attention to our unit. Our emergency center’s ICU is quite different from other departments’ ICUs. We have all kinds of patients," Su Hongbo said.

"Dr. Su, I won’t hide it from you; the two places I fear the most are here and pediatrics," Liu Banxia said with a bitter smile.

"Even though pediatrics is just downstairs, I rarely go there. It’s not because of my conflict with Director Chen; that’s all in the past. It’s because seeing children cry is more than I can bear."

"Who doesn’t feel the same? Can you suggest to the director that we be allocated one more attending physician?" Su Hongbo asked.

"Now that there are more patients, our workload has also increased. You’ve seen the schedules we submitted; we’re really burned out now."

Liu Banxia nodded. "I can assure you of this: our emergency center will definitely need to expand its staffing in the future."

"The emergency center is developing a bit quickly now, and we have quite a few patients, exceeding the hospital’s original projections. The hospital is also facing a personnel shortage, but our side will be prioritized for reinforcements."

"Wait until after the Spring Festival. I will arrange for the interns to rotate here. The ICU ward is the last task I’ve set for them. Those who can withstand the test here are bound to become good doctors."

"Finally, there’s a glimmer of hope. You observe here; I need to check on other patients," Su Hongbo said.

Liu Banxia collected his thoughts and began to consider the patient before him.

Heart failure is not an independent disease but a manifestation of the final stage common to all heart diseases. This means any heart disease can lead to heart failure.

The current treatments could only be considered temporary measures. They didn’t even truly maintain the patient’s condition; they merely slowed the disease’s progression. The patient had already developed liver failure, and other organs would follow.

There were many factors that could cause heart failure, such as infection, severe arrhythmias, a heavy burden on the heart, medication effects, emotions, and other diseases.

The patient was taking common over-the-counter cold medicine and hadn’t exceeded the dosage, so medication as the cause could be ruled out.

During admission, the patient was emotionally stable. Although there was some work stress, it wouldn’t lead to the current outcome.

A cardiac ultrasound had been performed; his cardiac physiological functions were normal. An ECG had also been done, and his heart rhythm was normal. So, the remaining potential causes were infection or other underlying diseases.

Even though many possibilities had been ruled out, the remaining two were not so easy to find.

There were numerous other potential diseases that could lead to heart failure, such as pulmonary embolism or severe anemia, but the patient’s current test results didn’t support these diagnoses.

His intuition told him that this patient’s condition might be related to an infection.

It was because he had previously encountered patients with high fevers caused by infections and subsequent inflammation.

Liu Banxia put on gloves and started a physical examination of the patient.

If it’s an infection, it might be related to some trauma the patient experienced. Even a small wound could cause an infection leading to sepsis.

Sepsis can also cause high fever and acute organ dysfunction. He currently had no leads, so he could only search blindly.

Even after using the ice blanket, the patient’s temperature was still somewhat high. Liu Banxia’s inspection was also very thorough; he carefully checked areas that are easily touched, like the hands, feet, knees, and elbows, for any signs of trauma.

He then thoroughly inspected the patient’s head to see if there were any unnoticed bumps.

Still, he was disappointed to find nothing. Trauma leading to infection could also be ruled out.

"President Liu, how is it? Any leads?" Su Hongbo, who had just completed his rounds, came over.

"I think it’s likely due to an infection, but I’ve carefully examined him and found no trauma," Liu Banxia said.

"If it’s an internal infection, we would have definitely found some lesion or other signs during the examination. Our examinations have been quite thorough, but we haven’t found anything," Dr. Su said.

"I’ve been mulling over this too. Could it be a blood-related issue? But again, the blood tests didn’t show anything, and it doesn’t fit the symptoms of leukemia," responded Liu Banxia.

Liu Banxia nodded. "During my examination, I also palpated his spleen and checked his cervical lymph nodes. Neither showed anything particularly abnormal."

"Hmm? If it’s a blood-related issue, could it be infectious endocarditis? I see acne scars on the patient’s face; could that have caused it?"

Dr. Su furrowed his brows, minutely examined the patient’s face, then shook his head. "That mark is from a long time ago. If it was indeed due to acne, the acne would definitely still be present." 𝒻𝑟𝘦𝘦𝘸ℯ𝒷𝑛𝘰𝓋ℯ𝘭.𝘤𝘰𝘮

"However, what you said about endocarditis seems plausible. There are numerous causes for endocarditis. Could it be that he originally had viral influenza, which then slowly led to a blood infection?"

"That seems unlikely as well. If that were the case, he would definitely show other symptoms; his condition wouldn’t be so ’clean,’ with nothing showing up in the tests."

"Is the patient’s family still here? I’ll go have a chat with them," Liu Banxia said, standing up.

"His wife is here; his parents haven’t arrived yet. They’ll get here tomorrow," replied Dr. Su.

Liu Banxia rushed outside and located the patient’s wife. She was of a similar age to her husband and was holding a five or six-year-old child in her arms.

"Hello, may I ask if your husband had any discomfort before he caught this cold?" Liu Banxia asked.

The patient’s wife thought for a moment, then shook her head. "He didn’t mention anything to me. He just started feeling a bit feverish. We initially thought he’d just caught a chill, a bit of a cold. We never expected it to turn into this..." The patient’s wife couldn’t continue, dissolving into tears.

"Please try to recall carefully. Think about any medications your husband might have taken. Sometimes, people don’t mention minor ailments they don’t consider serious," Liu Banxia suggested.

"For example, if I get injured, I might not tell my family to avoid worrying them. Did he suffer any external injuries recently? Even an accidental scrape or something like that?"

The patient’s wife still shook her head. "He doesn’t do that sort of work. He hasn’t had any injuries."

"What about his medication intake? Can you think back further, say, one or two months ago?" Liu Banxia pressed.

"One or two months ago? He had oral ulcers once, but they healed in a few days. He’s also prone to ’heatiness.’ When that happens, sometimes he gets blisters at the corners of his mouth, or he experiences toothache. Does that count?" the patient’s wife asked, trying hard to remember.

Prone to ’heatiness,’ oral ulcers, blisters, and toothaches. Liu Banxia muttered to himself, still without a clue.

As he thought about it, he suddenly frowned. "Did he ever say which tooth was aching?"

"I really can’t remember. All I know is that he had a toothache. It wasn’t very severe, and he felt better after taking some medicine. It was just due to the ’heatiness,’ probably a molar," the patient’s wife replied, starting to sound anxious.

"Please wait a moment; we’ll perform some more checks." After Liu Banxia finished speaking, he rushed towards the ICU.

"Did you find a clue?" Seeing his expression, Dr. Su’s face lit up with anticipation.

"I have a hunch. Let’s get a dental CT scan for the patient," Liu Banxia replied.

"What? A dental scan?" Dr. Su was taken aback.

"According to his wife, he’s prone to ’heatiness’ and subsequent toothaches. Relevant or not, we have to check it out," Liu Banxia explained.

"Alright, I’ll arrange it right away." After a moment’s thought, Su Hongbo’s eyes lit up, and he nodded emphatically.

This patient qualified for an expedited procedure. His situation was beyond critical.

Liu Banxia and Su Hongbo immediately made their way to the CT observation room to see the images as soon as they were available.

The wait was excruciating. But there was nothing they could do; the machine had its own processing algorithm and wouldn’t speed up just because they were anxious.

"Damn! You actually got it!" Su Hongbo exclaimed, slapping Liu Banxia hard on the shoulder when the scan results came out.

Liu Banxia also smiled. This time, it was truly a guess, but he’d guessed right.

The images clearly showed the patient’s lower right wisdom tooth was horizontally impacted. And not only was it horizontally impacted, but it was also unerupted and had already damaged the adjacent molar.

The elusive cause of the illness had been found. It was indeed endocarditis, caused by this damaged tooth. Because it was in the lower jaw, covered by the gingiva, even the patient himself wouldn’t have known about it.