The Enhanced Doctor-Chapter 424 patients sent from the sanatorium

(Thanks to my friends, The Road is Bumpy and Silence529, for their encouragement and monthly tickets)

Yesterday was rather rough for Liu Banxia, so he decided to sneak in some extra sleep at night.

Actually, he was quite comfortable being the chief resident. Everyone was very considerate of him; they wouldn’t bother him with situations they could handle on their own, allowing him to get some quality sleep.

They knew that despite seeming energetic every day, he was under immense pressure. Otherwise, he wouldn’t have been lying on the floor for so long yesterday, something they had never witnessed before.

After all, Liu Banxia usually projected an image of being full of fighting spirit and passion, as if nothing could stump him.

"President Liu, we just received a call from a nursing home. They’re bringing in a 75-year-old lady with a lump in her neck. Their staff physician suspects it’s a thyroid nodule," the dispatch nurse said.

"Did the nursing home send her, or did they call for an ambulance?" Liu Banxia asked.

"The nursing home sent her. Her children will also be here shortly," the dispatch nurse replied.

Liu Banxia nodded. "Okay, I understand. I’ll see her when she arrives."

This indeed needed clarification because it involved potential cost issues. That was the difference between a direct referral from the nursing home and an emergency ambulance call.

Not ten minutes later, a whirl of people came through the doors. The elderly lady walked in on her own, looking to be in fairly good health. The people accompanying her were presumably her children.

"Honestly, I’m already so old, and I’ve had this lump for several years. It’s been no bother," the old lady said.

"Mom, please get a proper check-up. Otherwise, we’ll keep worrying," said her slightly older daughter.

"Exactly, we’re already here. Doctor, please give her a thorough examination," the patient’s son said.

"Alright, everyone, please don’t worry. I’ll first give the lady a simple physical examination, and then we’ll do some diagnostic tests. If her condition permits, we might be able to do the procedure today," Liu Banxia said.

He had a good feeling; the family atmosphere was very positive. 𝐟𝗿𝐞𝚎𝚠𝐞𝚋𝕟𝐨𝚟𝐞𝕝.𝕔𝕠𝚖

Otherwise, he’d just been wondering why an elderly lady with children would be sent to a nursing home. He had suspected there might be some family conflicts. But it seemed that wasn’t the case, as a whole group of them had come along today.

Liu Banxia performed a brief examination. Through palpation, he discovered it wasn’t just one lump; it was likely a case of multiple nodules, present on both the left and right sides.

He then checked the old lady’s blood pressure and temperature. Surprisingly, her health was very good for her age; her blood pressure was normal.

This wasn’t common among the elderly, who often had issues like high blood pressure or diabetes, but this old lady had neither.

"Just now, during palpation, I felt several lumps, on both sides. Later, we’ll get a CT scan for the old lady to determine their exact location and number. Once an operating room is available, we can perform the surgery," Liu Banxia said.

"Doctor, is this surgery very risky?" the patient’s younger daughter asked.

"All surgeries carry some risk, but this particular procedure has relatively few associated complications," Liu Banxia replied.

"Thyroid cysts or nodules are actually common conditions. If the old lady only had one or two small nodules, we could observe them first and not intervene. However, there are quite a few now, so it’s better to remove them."

"These can be solitary or multiple. Multiple nodules have a higher incidence rate, but their chance of becoming cancerous is lower than that of solitary nodules. So, you don’t need to worry too much. Once we’ve confirmed the locations and completed all the tests, I will explain the detailed surgical plan to you."

"Doctor, if she undergoes surgery, how many days will she need to be hospitalized?" the patient’s son asked.

"That’s a bit hard to say. Normally, for similar surgeries, the hospitalization time is around three to seven days. However, it also depends on the old lady’s post-operative recovery, as everyone’s physical condition is different," Liu Banxia explained.

"Alright, I’ve prepared the initial orders. You can consider your options. If you decide to proceed with the surgery, I’ll then arrange for her admission. There’s no rush; please discuss it thoroughly."

This was the only advice he could really offer. If the patient were younger, he would have recommended the surgery, but she was, after all, a seventy-five-year-old lady.

Surgery on elderly patients inherently carries a higher risk, especially a thyroidectomy, which is far more complex than removing a simple subcutaneous lipoma.

Any surgical intervention causes some trauma to the body. The young and strong recover more quickly, while the elderly and frail recover more slowly and have a higher chance of developing post-operative complications.

After finishing the consultation with the old lady, he saw Zhang Xiao walking over and went directly to meet him.

"You were worried about that young woman, weren’t you? She’s fine now. We ran some tests this morning; everything is normal," Zhang Xiao said with a smile.

"Thank heavens! Yesterday was so harrowing. Have they figured out what caused it?" Liu Banxia asked, sighing with emotion.

"We found out. The young woman accidentally bumped her head while playing. At the time, she saw no bleeding, so she didn’t pay much attention to it. Because quite a bit of time had passed, she didn’t recall the incident," Zhang Xiao explained.

"You could say she was a bit unlucky. Usually, while such a bump can easily cause edema, the probability isn’t very high, but she happened to be the one."

"After the surgery yesterday, we drained the remaining fluid. Now, with medication and another day or two of drainage, she should be fine."

"If you hadn’t intervened yesterday, the outcome would have been really uncertain. I mentioned it to Director Xiao, and he said it was a pity you’re not in our neurosurgery department, lamenting that such skilled hands weren’t with us."

Liu Banxia rolled his eyes. "Even though that’s a compliment, I’m not happy. You have no idea how worried and exhausted I was yesterday."

Zhang Xiao patted his shoulder. "That’s because it was you. If it had been me, I might have caused some brain damage. I’m not just praising you; that’s the truth."

"This is an emergency procedure for brain herniation, a last resort. Whenever possible, the patient should be sent to the operating room for a rapid craniotomy. It’s like that cricothyrotomy from your general surgery department you always see on TV, right? Making an incision and inserting a pen tube or something."

"It’s not that such emergency measures don’t exist, but they are truly very dangerous. If you hadn’t been there, I would have had to attempt it. But you were there, and your hands are steadier, your touch more sensitive than mine."

"Brother Zhang, you don’t think I’m so petty that I’d be angry with you, do you? It’s fine, don’t overthink it," Liu Banxia said.

"It’s your prerogative if you don’t dwell on it, but I have to remember this, don’t I?" Zhang Xiao retorted.

This was no laughing matter. If the patient had truly run into trouble yesterday, Liu Banxia would have borne the responsibility. However, this responsibility wouldn’t be for medical malpractice but rather a humanitarian one.

After all, Liu Banxia was performing an emergency procedure. Even if he wasn’t a neurosurgeon, he could still perform it under the guidance of a doctor like Zhang Xiao.

But isn’t that how things are sometimes? Even if you act reasonably, it doesn’t guarantee a smooth outcome. If the rescue is successful, everyone laughs it off. If it’s not, given the temperament of that patient’s mother, it would surely be a different story.

"Brother Zhang, to be honest, I am a little resentful of you," Liu Banxia said, his face tightening.

"I mean, I worked so hard yesterday, so why didn’t you get me an extra chicken drumstick or something last night? I waited for ages, and no one bothered with me."

Zhang Xiao shot him an irritated glance. He’s being cheeky again.

"Weren’t I assisting the Director as first assistant in a surgery? By the time I got out, you were already asleep. I’ll get you chicken drumsticks for lunch—two of them," Zhang Xiao said.

"Haha, it’s a deal! Two drumsticks!" Liu Banxia agreed with a grin.

And just like that, the matter was considered settled. Liu Banxia hadn’t really been bothered by it in the first place. If Zhang Xiao hadn’t brought it up, he wouldn’t have even thought about it that way.

"President Liu, a car accident patient is on the way. The driver had a seizure while driving, causing the accident. He has a laceration on his head," the dispatch nurse called out again just then.

"Brother Zhang, don’t rush off! Help me with this patient," Liu Banxia quickly called out.

Zhang Xiao, who hadn’t gone far, quickly turned back.

"Thirty-seven years old, had a seizure while driving, lost consciousness after the accident. Head laceration, dislocated elbow. He regained consciousness in the ambulance after receiving oxygen. Current vital signs are stable," reported the paramedic wheeling the patient in.

"Okay, no need for the resuscitation room for now; an examination bed will do. Were there any specific warning signs before the seizure?" Liu Banxia asked, turning to the patient.

"No, I just suddenly blacked out. When I came to, people were rescuing me," the patient said.

"Connect the monitor, draw blood. Dr. Zhang, examine his head and neck. Xu Yino, perform the initial trauma assessment. I’ll reduce the dislocated elbow," Liu Banxia instructed.

Everyone got to work.

Liu Banxia merely palpated the elbow area and, without warning the patient, performed a quick stretch, pull, and lift, successfully reducing the dislocation.

The reduction was quite painful, causing the patient to gasp sharply and suck in his breath for a good while.

"Get another X-ray of the elbow," Liu Banxia instructed.

"The neck seems fine, and the head wound isn’t very serious. I suggest we do a head MRI directly. We can treat the head wound after the scan; it’s stopped bleeding now," Zhang Xiao advised.

"Physical examination and ultrasound show no abnormalities. Vital signs are stable," Xu Yino reported.

DING! Consultation complete.

Gained 200 experience points, 100 proficiency points for Diagnosis Skill, and 100 proficiency points for Bone-Setting Skill.

"Okay, let’s follow Dr. Zhang’s plan: MRI and X-ray," Liu Banxia nodded.

"Once the results are out, if you don’t need me, you can arrange the next steps yourself. Just call me if you do," Zhang Xiao said.

"Alright, you go get busy then. Hopefully, we won’t need to call you; that would mean this patient is very fortunate," Liu Banxia replied.

For now, this patient was indeed fortunate; his external injuries were unlikely to have any significant long-term impact.

Next, they had to see if there were any issues within his brain. It’s not just potential edema or bleeding we’re worried about, but also the possibility of a brain tumor.

The sudden onset of seizures is often related to organic brain lesions. Of course, issues in other parts of the body could also cause them, but brain pathologies are a more common cause; otherwise, Zhang Xiao wouldn’t have ordered an MRI straight away.

Whether the patient’s luck would hold depended on his examination results.