The Enhanced Doctor-Chapter 413 Meaty Tumor

Actually, Liu Banxia was itching to operate. As a surgeon, especially one who loved performing operations, how could he not be tempted by a surgical opportunity? Not to mention he had been idle for so many days. It was like a child who loved kiddy rides spotting an empty one, especially when the ride seemed to call out, "Little boy, little girl, come and play!" The feeling was very similar.

But rules had to be followed. Even though Zhou Shuwen was his teacher and the director of the Emergency Center, keeping him from operating was for his own good, and once an order was issued, it had to be adhered to.

After explaining things to the patient’s son, he strolled back to the first-floor lobby. As soon as he arrived, he saw Qiaoqiao waiting for him, a wide smile on her face.

"Why did you come over?" Liu Banxia asked joyfully.

"To have a meal with you. Your parents were taken out to eat by Uncle Qiu and my dad. It’s no fun by myself," Qiaoqiao said.

"Hehe, just wait a little longer, and then we can go eat," Liu Banxia stated. "I just sent a patient to the operating room. How did things go last night? I didn’t sleep well; I’ve been worried sick."

"Of course, everything’s fine. Your dad, my dad, and Uncle Qiu had a great time drinking together," Qiaoqiao said. "Actually, I was quite worried at first, but they hit it off as they chatted. Otherwise, they wouldn’t be out together today. So, don’t worry."

Liu Banxia nodded. "Then I’m truly relieved. It’s been a bit busy these days, and I have no idea when my next day off will be."

"President Liu, a truck driver with acute abdominal pain is being brought over by the traffic police. He was sent directly from the highway," the dispatch nurse called out at that moment.

"Okay, leave him to me," Liu Banxia responded, then turned to Qiaoqiao. "Be good and wait for me in the lounge. We can’t delay treating a patient with acute abdominal pain."

"Ugh, so annoying. You’re treating me like a child. Qing Kewa and Liang Xiaolin are coming for lunch. If you’re busy, the three of us will eat together." After saying that, Qiaoqiao, familiar with the way, headed to the lounge.

Qiaoqiao could be quite mischievous. However, Liu Banxia had no time to think about romance; a patient with acute abdominal pain couldn’t afford any delay.

After waiting for less than three minutes, the traffic police brought the patient over.

"What’s the exact situation?" Liu Banxia asked the traffic officer who was supporting the patient.

"He’s a truck driver. He asked us for help at the service area. He said his stomach hurt and he was having trouble breathing, so we sent him straight here," the traffic officer reported.

"I’m feeling a bit better now. I have diverticulitis. I forgot to bring my metronidazole on this trip," the patient said weakly.

"We still need to check you out first; otherwise, these two officers will have brought you here for nothing," Liu Banxia replied. "And even if it is just a diverticulitis flare-up, you typically experience abdominal pain. Now you also have difficulty breathing. We mustn’t overlook that."

The patient nodded and lay down on the examination bed.

Although the patient had mentioned his diverticulitis, Liu Banxia still followed standard procedure for his examination. He had to rule out appendicitis and cholecystitis, and he even performed a percussion test for kidney stones.

"Your lung sounds were a bit abnormal during auscultation. We need to take a chest X-ray and do a barium enema," Liu Banxia stated.

"Doctor, just give me the medicine. I’ve experienced this pain before; it gets better once I take it," the patient responded. "The examinations will take too much time. After taking the medicine and resting for a bit, I can continue with my delivery. The cargo owner has a deadline. If I don’t deliver on time, I’ll be fined."

"I understand you’re in a hurry, but we really can’t give you medicine before we have a definitive diagnosis. Even as a doctor, I don’t have that authority," Liu Banxia explained patiently.

"That’s right. In your condition, we can’t let you drive. If you need any official documentation, we can help provide a certificate. Otherwise, if you suddenly fall ill again on the highway, it would be incredibly dangerous," one of the accompanying traffic officers added.

"It’s just my old problem... COUGH, COUGH, COUGH... PTOO!"

The patient’s words were cut short by a series of violent coughs, and he ended up spitting out a mouthful of blood.

Liu Banxia quickly helped the patient into a semi-recumbent position on the bed. "Connect him to the monitor and bring me the portable ultrasound machine!"

He then supported the patient’s head and checked his airway.

"Airway is clear, no foreign objects. Blood oxygen is very low. Give him oxygen, five liters," Liu Banxia ordered after careful observation.

"President Liu, the patient’s heart rate is a bit fast, and his blood oxygen is decreasing," the nurse announced, having connected the monitor.

"I’ll do an ultrasound first," Liu Banxia stated.

The two accompanying traffic officers looked nervous. To an ordinary person, seeing someone cough up blood signified a serious illness.

"There’s fluid in the lungs. We still need to intubate. 100 units of succinylcholine, 20 units of etomidate. Get the intubation kit," Liu Banxia ordered after finishing the ultrasound.

Tearing open the intubation kit, Liu Banxia carefully intubated the patient.

Although he didn’t perform this procedure often, usually leaving it to others, his skills in this area were impeccable. But just as he withdrew the stylet from the endotracheal tube, a gush of chyle-like fluid spurted from the tube.

"This might be a ruptured thoracic duct. Diverticulitis wouldn’t cause this symptom. Run a blood test and take the patient for an urgent chest MRI," Liu Banxia said. "Officers, it would be best if you could contact his family. Do you know if the patient has recently suffered any impact injuries to his chest?"

The traffic officer shook his head. "We’re not sure, but we’ll contact his family as soon as possible. Doctor, was this caused by an impact?"

Liu Banxia shook his head. "I just checked his chest and found no bruising, so we can mostly rule out an impact injury. A thoracic duct rupture could be caused by an infection or a tumor. We’ll know more when the MRI results are back."

There was also the possibility of heart failure, but he had just confirmed normal heart sounds, and the patient’s blood pressure was within the normal range, so that could be temporarily ruled out.

"Emergency patient?" Shi Lei walked over at this moment.

"Yes. His main complaint was diverticulitis, but before I could even examine him, he started coughing violently, spat blood, and suddenly developed chylothorax. I suspect a ruptured thoracic duct," Liu Banxia said. "He’s gone for an MRI first. We’ll consult with the cardiothoracic team when the scans are back. It might be lymphoma or sarcoidosis, or something similar. The diverticulitis is secondary now."

Shi Lei nodded. "You’ll be able to get your stitches out tomorrow, right? Once they’re out, get back to clearing the surgical backlog. I’m exhausted. Everyone’s swamped, and you’re the only one taking it easy."

Liu Banxia gave him a helpless look. "I just dealt with a ruptured abdominal aortic aneurysm. My hands are itching to operate. Qing Kewa, go to the lounge; Qiaoqiao’s there."

"Okay! And you didn’t even tell me," Qing Kewa grumbled before scampering into the room.

"I’m in a hurry too. I’ve already got a backlog of ten small-incision appendectomies and five cholecystectomies," Liu Banxia said. "I’ve actually advised the cholecystectomy patients to choose other doctors. It’s just a routine laparoscopic procedure, yet they insist on me. It’s one of the side effects of being on TV, I suppose. Not so easy to manage."

"If I didn’t know you so well, I’d think you were showing off," Shi Lei chuckled. "Anyway, you’re quick with surgeries. Get them scheduled, book the ORs, and channel the same energy you had when you were blazing through surgeries before. You’ll manage. At least it will help boost the Emergency Center’s profits. Otherwise, it looks like we might be in the red again this month, right?"

Mentioning this gave Liu Banxia a headache; it was indeed the situation.

Some patients’ medical fees were pending procedural approvals, while others genuinely couldn’t pay for now. Then there was the female university student in the ICU. Even with medical insurance, there would still be out-of-pocket expenses. Not to mention she had undergone ECMO, and there was no telling how long she’d be in the ICU. If she was saved, everyone would rejoice. If not, it would be a different story.

This was the unique nature of an Emergency Department or an Emergency Center: their primary purpose was to save lives. That’s why they relied on patients who came in voluntarily for treatment; if they only handled patients brought in by ambulances, they probably wouldn’t last more than a few months.

At this time, Liu Banxia’s cell phone rang. The patient’s chest MRI results were ready, and he quickly accessed them on his computer.

The MRI scans clearly showed a mass in the lung, requiring further investigation.

Ding! Admission completed.

Received 200 Experience Points, 200 Diagnosis Skill Proficiency Points, 200 Dressing Change Skill Proficiency Points, 2 Glory Points.

Now he really had no choice but to call in a cardiothoracic surgeon for a consultation. This type of pathology was beyond Liu Banxia’s scope as a general surgeon.

"There’s a high probability it’s a granuloma. Let’s do a biopsy first," said Wu Xiaoyue, who had come for the consultation. "The only fortunate thing at this point is that it hasn’t invaded the central nervous system. This gives us a chance, regardless of whether it’s benign or malignant."

"Next, we need to perform a biopsy, and you’ll need to be admitted to the hospital," Liu Banxia said to the patient, who had just been wheeled back.

The patient pointed at his breathing tube.

After a moment’s hesitation, Liu Banxia removed the endotracheal tube.

"Doctor, is it lung cancer?" the patient asked, his voice somewhat strained.

"Broadly speaking, yes. But we can’t determine if it’s benign or malignant yet," Liu Banxia said after a thought. "If it’s benign, we only need a very simple surgery to remove it. Even if it’s malignant, we can often control it with radiotherapy and chemotherapy after surgical removal."

"Without detailed test results, we can’t be certain, which is why we need the biopsy. Considering your current health condition, I suggest you find a colleague to deliver your cargo."

The patient fell silent.

"I don’t have medical insurance. Can I hold out until my medical insurance coverage kicks in?" the patient asked after a moment of silence.

"We still need to perform the biopsy. If it’s benign, we would only need to perform a relatively minor standard surgery," Liu Banxia said, hesitating slightly.

He could only say this much. Even though his medical knowledge told him the probability of malignancy was high, without a definitive biopsy result, he had to describe it in the least alarming way possible.