The Enhanced Doctor-Chapter 432 Complex Abdominal Pain Patients

(Thanks to my dear friends Pirate Flag Hino, Elephant, Serene Valley Pavilion Master, Book-Devouring Fungus, and Chen Wenlong for their encouragement with monthly tickets)

"Don’t get discouraged. This won’t have a significant impact, and you’ll remember it when you encounter similar patients in the future," Liu Banxia offered more encouragement.

"Teacher Liu, have you come across such a patient before?" Miao Rui asked with curiosity.

Liu Banxia shook his head. "I’m encountering this for the first time as well."

"Then how did you think of it?" Miao Rui asked further.

"Silly, have you forgotten that I know how to perform bone-setting techniques? I’m not always fully confident when I’m treating obese patients. Her neck is so thick that I might not even be able to determine its location without careful examination," Liu Banxia explained.

The three were taken aback and realized that this really was the case. However, how was it that Teacher Liu could think of such a simple rationale that they couldn’t?

"That’s why I’m the teacher and you’re the interns. Once you’ve graduated and become resident doctors, you can educate the new interns in the same way," Liu Banxia said, chuckling.

Although it was just an offhand joke, the three of them burst into laughter.

Educational work shouldn’t involve endless criticism. The pressure here is already strenuous, and constant criticism might discourage anyone from persevering.

As he stepped out of the emergency room, he saw Wang Huan walking out of the internal medicine clinic, waving at him.

"Brother Wang, what’s the situation?" Liu Banxia asked.

"We have a patient here. Her boyfriend brought her in, and she’s a bit emotionally unstable. She’s experiencing dull abdominal pain, but it’s not severe," Wang Huan replied.

"During the initial diagnosis, we ruled out appendicitis and cholecystitis, and went straight for a CT scan. The results just came out showing that everything is normal, and the blood test is also normal."

"The patient had enteritis a week ago and has taken Compound Sulfamethoxazole Tablets. We have ruled out allergic reactions to sulfonamides, so I’m seeking your help."

Liu Banxia also found it a bit of a headache. He followed Wang Huan into the consultation room. He paused slightly, realizing the waiting young man he had just seen was the patient’s boyfriend.

"By the way, why didn’t we do an ultrasound examination?" Liu Banxia asked after reading the blood test report.

Wang Huan shook his head. "The patient was very resistant, so we went straight for a CT scan."

"Young man, does your girlfriend have any other symptoms?" Liu Banxia asked the young man after pulling him aside.

The young man shook his head. "There are no other symptoms. She has just become irritable and taciturn after that bout of enteritis. This has caused me a lot of worry these past few days."

"What was her personality like before?" Liu Banxia continued to ask.

"She was fine before, although a bit introverted, but not like how she is now. Doctor, how about we do an MRI? Isn’t it said that MRIs give a more accurate and advanced diagnosis?" the young man suggested.

"That’s not really the case. Basically, CT and MRI scans yield similar results. However, I suggest that you talk to her about undergoing a colonoscopy," Liu Banxia said.

"It’s possible that there are issues with her intestines. Until we do a detailed examination, we can’t make an accurate diagnosis. If we still can’t find any problems after the colonoscopy, we’ll have to add a urine and stool test."

"If nothing is found in all the above examinations and the patient’s pain doesn’t alleviate, our only option will be a laparoscopic exploration to see if there are any minute changes we missed."

The young man nodded his head, looking rather worried. If this were his girlfriend from before, she would have smoothly completed all these examinations. But now, she was so reluctant that he had to insist she even come to the hospital.

They gave some time for this young couple. More often than not, persuasion from family members is more effective than a doctor’s.

But even so, the young man had to coax her for over twenty minutes before she reluctantly agreed.

"It’s a bit of a headache. I can’t diagnose the patient’s condition, and she’s not easy to communicate with. I ask her ten questions, and I’m lucky if she answers three; her boyfriend does most of the talking," Wang Huan said.

"She also has significant resistance during the physical examination. When I proposed an ultrasound, she shook her head immediately. I only found out later from the young man that they had a child before, but she had a miscarriage."

"She was a bit mentally unstable after the miscarriage, and the young man is worried that she might revert back to how she was. Based on my observations and judgment, it’s challenging to determine her condition, but she seems to exhibit some signs of depression."

"The miscarriage was last year. If the symptoms were due to that, it’s unlikely they would have dragged on until now. I’m really stumped now and counting on you."

"I’m also at a loss. I’ve already told the young man that the last resort is to perform a laparoscopic examination. We’ll wait and see the results of the colonoscopy first; there isn’t much else we can do," Liu Banxia said.

Outside, Huang Bo came over. "Teacher Liu, the CT test results for the car crash patient earlier are normal. The failed intubation was due to swelling compressing the airway. Our cricothyroidotomy certainly saved the patient’s life."

Liu Banxia nodded his head with a smile. "That’s not bad. After all, it’s an invasive examination; it’s better to avoid it if we can."

"Teacher Liu, what kind of case did Teacher Wang consult you on just now?" Huang Bo asked with curiosity.

"She has abdominal pain, but her CT and blood tests are normal. She’s undergoing a colonoscopy now. She also shows signs of depression and resists examination. Tell me, isn’t that troublesome? If you were treating her, what would you do?" Liu Banxia asked.

Huang Bo was dumbfounded. Just confronting a patient with tendencies towards depression and reluctance to be examined left him at a loss, let alone when the cause of the abdominal pain couldn’t be diagnosed.

"If it weren’t for the patient’s emotional issues, I would have planned to let you guys observe at Doctor Wang’s clinic. It’s also a great opportunity to accumulate experience. When you’re independently managing patients in the future, you’ll encounter cases like this," Liu Banxia said.

"Anyway, in our profession, we learn as long as we live. No one can hope to understand everything while they’re alive. Once we’re dead, we lose the chance to learn." 𝙛𝒓𝓮𝒆𝔀𝒆𝙗𝓷𝒐𝙫𝒆𝙡.𝒄𝓸𝓶

Huang Bo grimaced. This speech was somewhat disconcerting, but it was also the truth.

"Keep going, young man, we have to endure it bit by bit." Liu Banxia patted his shoulder.

Huang Bo nodded. In this profession, ’endure’ was truly the right word to describe the daily grind.

"Sister Li, what’s going on?" At that moment, Liu Banxia saw Zhou Li’s resentful expression, which bewildered him.

"It’s that old lady’s daughter again. Truly, I’ve never encountered such a person before," Zhou Li said, forcing a bitter smile.

"What happened today? Isn’t the old lady recovering quite well?" Liu Banxia asked.

"She is recovering wonderfully, but her daughter doesn’t want to stay here and keep her company tonight. She wants to go home," Zhou Li said.

"That’s okay, isn’t it? Aren’t there others to keep her company?" Liu Banxia said casually.

"Others? I haven’t seen anyone else," Zhou Li retorted disdainfully.

"Yesterday, a whole crowd was bustling about, discussing what to eat and drink. Today I only saw the old lady’s three daughters. The other two just popped in and out. The nurse said they weren’t even here for 20 minutes."

"Her son hasn’t shown up at all. Her grandsons, granddaughters, I bet, are at home stewing black chicken soup. Yesterday, they were all going on about it—I reckon they want to stew the chicken bones to mush; otherwise, how could they stew it for so long."

Liu Banxia was taken aback. He hadn’t expected this situation in the old lady’s family.

"Sister Li, every family has their own hardships. Maybe they have special circumstances at home. We can’t interfere. If it becomes unbearable, we’ll just have to pay more attention at night," Liu Banxia said.

You didn’t even have to ask. Zhou Li was so angry, undoubtedly because no one else would be coming to stay with the old lady tonight. Maybe it’s inconvenient for her son to stay overnight, but what about her two daughters?

Zhou Li nodded. "Don’t worry. Even though I’m annoyed with her daughter, I’ll still provide proper care for the old lady. However, there are many things to consider during night rounds; doing them too frequently might cause dissatisfaction among other patients."

"I’m relieved knowing you’re here, Sister Li. Sister Wang took leave for a couple of days due to some issues, but she called me and will be back at work tomorrow," Liu Banxia said.

"Rest assured, I’m fine; professionalism is essential. It just doesn’t sit right with me. Anyway, I’ve said my piece. I’m going back to work now," Zhou Li tossed out a remark and walked off to the side.

Liu Banxia felt a slight headache. As the number of patients increased, the nurses’ work also became increasingly difficult. Luckily, the old lady’s recovery was progressing decently, and she would be discharged in a few days.

However, he couldn’t help feeling quite emotional. The hospital was everywhere full of ’illusions’. Such a seemingly lively family, so apparently concerned for their elderly mother. And what now? It turned out to be all for show.

If they were busy during the day and didn’t have time to accompany their mother, it would be understandable. They couldn’t all be working overtime at night, could they? Judging by the two daughters’ age, they should be close to retirement, right?

Although he didn’t quite agree with it, it was none of their business. It was the patient’s family’s affair.

He was again considering Wang Huan’s patient. If laparoscopy could be avoided, it should be. It was an invasive exploration and somewhat harmful to the patient.

After a while, Wang Huan waved him over.

"Are the colonoscopy results out?" Liu Banxia asked.

"No polyps or lesions were found. They called me so that we could be prepared," Wang Huan said.

Liu Banxia gave a wry smile. The patient was already resistant to examinations, and now the tests have found nothing. The upcoming ’interaction’ with this patient would be a serious challenge.

Scare tactics wouldn’t work. Given the patient’s current psychological state, if you try to frighten her, she might just leave immediately.

DING! Complex abdominal pain patient

Open task: The patient has abdominal pain, and the cause is currently unclear. The host needs to make a further judgment. Task rewards will be given based on the diagnostic results.

This gave Liu Banxia an even bigger headache. A task had even been issued?

All pain has a reason. This patient has abdominal pain, so it’s highly probable there’s an internal issue. Since the CT scan and colonoscopy results are normal, what else can be done? If worst came to worst, he would have to persuade the patient to undergo an ultrasound to scan her pelvic area.