The Enhanced Doctor-Chapter 444: A false alarm

Wang Chao’s assessment of Liu Banxia was a bit generous. Although he could get by in any department, he was still a long way from being an expert.

Even so, his performance was already quite outstanding. In fact, many doctors practiced both internal medicine and surgery, though they tended to focus more on their own area of specialization.

Orthopedics was just a branch of surgery; so were cardiothoracic surgery and neurosurgery. Years ago, before specialties were so finely divided, doctors were often rotated between departments.

His work in the orthopedics department that day wasn’t much different from his part-time shift in pediatrics the day before. He mostly dealt with minor cases, primarily dislocations. Nowadays, the most common dislocations people suffered from were of the shoulder joint and the small facet joints of the spine.

These tasks were routine for him. The basic procedure involved looking at an X-ray, reducing the dislocation, sending the patient for another X-ray, and then moving on to the next.

Although these were minor tasks, he worked much faster than the interns and nurses in the orthopedics department.

Wu Mingyu, when seeing patients, would be more meticulous. He would take some time to examine the X-ray before proceeding. With Liu Banxia, however, it was different. He’d just take a quick look, feel the area a couple of times, and finish the job while chatting.

"Teacher Liu, the blood test results for the elderly gentleman are out. His white blood cell count is a bit high. Dr. Shi asked me to inform you."

Zhou Qian found him while he was busy.

"Don’t lift heavy objects, get a back brace, and we’ll take another X-ray later," Liu Banxia instructed the patient who had just had a small joint reduction, then turned to Zhou Qian.

"Were there any other abnormalities in the blood test? What did Dr. Shi say? Has the patient’s family been found? Has his temperature risen any further?"

"The white blood cell count was the only abnormality; it’s elevated. Dr. Shi has arranged for the patient to have a chest X-ray to check for pneumonia. The police still have no leads on his family, and his temperature has risen by another degree Celsius," Zhou Qian reported hurriedly.

"Okay, thanks. Let me know when the chest X-ray results are available. Call in the next patient," Liu Banxia nodded and also spoke to the nurse nearby.

Zhou Qian quickly hurried out. Liu Banxia’s instructions were her top priority; they had to be carried out faithfully.

The next patient was a young man in his twenties, who walked in tiptoeing and clutching his waist.

"What’s the problem?" Liu Banxia asked.

"I fell while playing basketball with friends some time ago. I didn’t feel much then, but it’s been a bit painful these last couple of days," the young man said.

"Lower back pain?" Liu Banxia asked.

"My hip," the young man quickly replied.

"I’ll examine you first. Is the pain sporadic or persistent? Is it very intense when it does hurt?" Liu Banxia asked.

"It’s not exactly continuous, but when it hurts, it can last for a while. It’s not very intense, though; ibuprofen at home usually helps," the young man said.

"But it’s been hurting for over half a month now, and I keep feeling like something’s not right. Could it be a hairline fracture or something? It was a pretty hard fall."

"From my physical examination, your lumbar spine seems fine, and I also palpated your coccyx. Let’s get an X-ray of your pelvis. The tissue here is thick, so I can’t feel anything definitive through palpation," Liu Banxia said.

"Doctor, if my pelvis is fractured, will it affect my daily life?" the young man asked anxiously.

"That depends on the actual situation. If it’s just a small crack, you’ll just need to be careful in your daily activities. Don’t jump to conclusions; go get the X-ray first. It might just be a soft tissue contusion," Liu Banxia said.

The young man nodded, clutched his waist, and tiptoed off to pay for the X-ray.

"Dr. Liu, there are two fracture patients left," the nurse said.

"In that case, could you call the operating room and ask when Doctor Wu might be free? Are these two fractures severe?" Liu Banxia asked.

"Not very serious. They both came in on their own for treatment," the nurse replied.

"Alright then, I’ll see them both. If anyone needs internal fixation surgery, we’ll call another doctor," Liu Banxia nodded.

He couldn’t handle overly serious cases, as he didn’t have the surgical privileges for them.

Of these two patients, one had a fracture from arm wrestling, and the other from slipping on ice and bracing the fall with their hand. After a brief manual examination, Liu Banxia sent them for X-rays.

This could be seen as a peculiarity of orthopedics. X-rays were indispensable for diagnosis. Moreover, this was the proper procedure; it had to be done this way.

"Dr. Liu, the elderly gentleman has some inflammation in his lungs. Dr. Shi has prescribed an levofloxacin infusion," Zhou Qian ran over again.

"Alright, I have three more patients here. Once they’re taken care of, Doctor Wu should be free," Liu Banxia said.

The elderly gentleman’s condition was as expected. After all, he had been exposed to the cold the previous night.

At this moment, the young man who had gone for a pelvic X-ray returned. "The doctor over there said it looks like I have some bone spurs on my right hip joint, but further examination is needed."

Liu Banxia took the films, clipped them onto the view box, and examined them carefully.

He frowned slightly. "Let’s do an enhanced MRI."

"Doctor, is it very serious?" the young man asked.

"It’s hard to say right now. An MRI offers higher precision. We’ll have a clearer picture once the new films are out. Let’s also draw some blood for an antibody test," Liu Banxia said.

The young man glanced at him and nodded. He had developed a bad feeling on his way back. Now that Liu Banxia was asking him to undergo an MRI, he felt even more apprehensive.

Liu Banxia sighed inwardly. The radiology department hadn’t explained things clearly to the young man. However, because the X-ray image was relatively fuzzy, it was somewhat difficult to make a definitive judgment.

According to his assessment, it looked like a tumor. It was already pressing on the surrounding tissue, causing the dull ache. However, the tumor was still quite small, which was why the X-ray film wasn’t very clear.

The tests he ordered were comprehensive and would provide a clearer picture once the results were in.

The young man with the arm-wrestling fracture also returned with his films. Liu Banxia glanced at them; his initial judgment was correct—setting it and putting it in a cast would suffice.

The patient with the wrist injury was a bit more complicated; this one would require surgery for reduction. There were many blood vessels in that area; he couldn’t risk it with the patient.

His part-time work here was quite fruitful, earning him 120 experience points, 170 diagnostic skill points, and 800 orthopedic skill points.

"Dr. Liu, Dr. Shi wants to see you. The elderly gentleman’s temperature has risen another half degree; it’s 38.7 degrees Celsius now," Zhou Qian ran over, breathless.

Liu Banxia was startled; this wasn’t a good sign. They had already administered medication, and a significant amount of time had passed. The drug should have taken effect by now under normal circumstances.

"Banxia, I just auscultated his lungs and didn’t hear anything abnormal. Apart from the high fever, he has no other symptoms, and he’s not coughing," Shi Lei said.

"Currently, if his temperature continues to rise, we’ll have to resort to Physical Cooling and run more tests. This persistent high fever is concerning. I’ve already given him an additional injection of Compound Aminopyrine Barbital."

Liu Banxia nodded. "We can only observe for now. This elderly gentleman’s case is somewhat unusual. Has his family still not been found?"

The police officer shook his head. "We’ve contacted numerous community offices, and now we can only conduct a door-to-door search in various residential areas."

"Judging by the elderly gentleman’s attire, he likely lived in a good neighborhood. But even so, a well-off community shouldn’t let an elderly resident wander out alone like this, right?" Liu Banxia frowned.

"And when he first arrived at the hospital, the old man seemed a bit confused and kept mentioning catching cats... Good heavens, how could I have been so muddle-headed? Dr. Shi, could it be Cat Scratch Disease?"

Shi Lei looked at him helplessly. "You had me worried for nothing all this time! Well, that settles it. Sloppy of you; lunch is on you today."

"My treat, my treat, absolutely my treat," Liu Banxia hurriedly said.

It was indeed his fault. Because of his oversight, everyone had been unnecessarily anxious all morning. He’d have to endure it even if Shi Lei chewed him out.

"Dr. Liu, what’s Cat Scratch Disease? Do you get a high fever just from a cat scratch?" the police officer nearby asked curiously.

"More or less. It’s an illness caused by bacteria transmitted through a cat scratch or bite, leading to fever," Liu Banxia explained.

"Initially, I thought the elderly gentleman was speaking nonsense when he mentioned ’catching cats.’ Now it seems he really was trying to catch a cat. The scratches on his hand will likely develop some papules or small blisters in a while, but that’s nothing serious."

"Dr. Shi, I need you to keep an eye on things here for a bit longer. That patient in orthopedics went for an enhanced MRI; it might be bone cancer, and I need to go back and monitor the situation."

With that, Liu Banxia hurried back towards the orthopedics clinic, looking a little flustered.

He still felt a bit sheepish. For someone as "competent" as himself to make such a rookie mistake... This incident would probably be the talk of the Emergency Center for some time. What could he do? It was his own blunder, prime material for teasing.

When he returned to the orthopedics department and waited for a while, the patient hadn’t come back yet, but Wu Mingyu arrived.

"Caused by a glass ashtray. Probably fell from a high floor; it hit him pretty hard," Wu Mingyu said.

"I’ve handled the other patients for you. There’s one who went for an enhanced MRI; he might have a small tumor on his right hip bone. And another patient has a wrist contusion; I didn’t dare to attempt a direct reduction," Liu Banxia reported.

Wu Mingyu frowned. "If it’s malignant, do we keep him here or send him over to Director Xu?"

"Let’s keep him here; we have more beds available on our side. And treatment-wise, it’s generally the standard approach, right? A more advanced option would be hip replacement, right?" Liu Banxia asked.

Wu Mingyu nodded. "If it’s caught early, even if it’s malignant but hasn’t metastasized, the prognosis after a hip replacement is better. However, chemotherapy will still be necessary, and the overall cost is quite high."

It was an unfortunate reality; tumors that grew on bones were very rarely benign.