The Enhanced Doctor-Chapter 451 Key Lunch

"President Liu, the patient insists on natural realignment." 𝐟𝚛𝕖𝚎𝕨𝗲𝐛𝚗𝐨𝐯𝐞𝕝.𝐜𝗼𝗺

After waiting a while, Qi Wentai found him.

Liu Banxia sighed. "Did you explain the risks to the patient and their family?"

"We did, but the patient’s attitude is very firm." Qi Wentai nodded.

"Then let’s monitor them closely. Tell the nurses to be extra vigilant, and also tell the patient’s family to stay by their side at all times. If anything seems wrong, or if the condition worsens, take them directly to the operating room," Liu Banxia said.

"President Liu, if surgery is really necessary, will you perform it?" Qi Wentai asked cautiously.

"What’s there to worry about? Your skills are no worse than mine. This is just a routine surgery. If it can be realigned, we’ll realign it. If not, we’ll resect it," Liu Banxia said with a smile.

"You just need to be a bit more careful during the procedure, don’t worry so much. If there’s a chance, bring a few more interns. It’s also a very good observational opportunity for them. Moreover, there are indeed some risks associated with operating on pregnant women. Explain any potential problems you can think of to them as well. Once we’ve trained them properly, we’ll have an easier time after July. You haven’t had a proper vacation in a long time, have you?"

Qi Wentai smiled and nodded. "Sometimes, I wish I could sleep for three days and three nights straight. Well, I’ll go explain things to the patient and their family first."

Even though Qi Wentai was merely following procedure by coming to ask for instructions, Liu Banxia was quite pleased about this. Their relationship was somewhat complex, wasn’t it? But now it seemed there were truly no problems anymore.

He thought he was done worrying about that unfortunate man who’d faked the accident, but less than an hour later, he had to deal with it again.

The matter was simple: they hadn’t gathered enough money for the surgery, yet they were demanding the highest standards of treatment. The shortfall was not insignificant, encompassing the choice of instruments, medications, and so on. And so, the decision on this matter was pushed to Liu Banxia.

"First, restore blood supply and suture the tendons. This will buy them enough time to raise the money. If they still can’t manage it, we’ll have to proceed according to hospital regulations," Liu Banxia said after a moment’s thought.

"The patient’s family is very agitated. I’m afraid I won’t be able to communicate with them effectively," said Wu Mingyu.

"It’s alright. Officer Xu is still here. If there are any issues, just find Officer Xu," Liu Banxia said.

"Actually, there isn’t a huge difference in quality between domestic and imported steel plates nowadays. To fully fix his arm, it will cost over a hundred thousand yuan, and that’s not even counting the subsequent rehabilitation expenses. If they also opt for high-standard medications, I really don’t know what they’ll think when they’re faced with enormous bills for medicine and equipment later on. Just follow the regulations. If anyone tries to cause trouble, send them to me. I reckon they’re still hoping to get a payout from the car owner, that’s why they’re trying to get the best of everything."

"Alright, I’ll relay it that way then." Wu Mingyu nodded.

With Liu Banxia’s approval, Wu Mingyu felt more assured. This was also a procedural matter; as long as the procedure was followed correctly, there would be no issues.

He then checked on the child with abdominal pain again. The child was currently fine. This was very strange; it was almost like a heart condition. Perhaps this is sometimes the helplessness of being a doctor; we’re not omnipotent. We have to wait for the symptoms to manifest to point us in the right direction, especially when all the diagnostic tests come back normal. If I were the parent, I’d probably suspect my child was faking illness too.

The morning passed just like that. The various departments submitted their requested dishes. Liu Banxia didn’t bother removing duplicates, simply printed the list, and took it to the cafeteria.

"President Liu, Doctor Wang just instructed that we add a chicken leg for you, but it has to be the smallest one," Zhou Qiang said, coming forward to greet him.

"Haha, no problem. Since it’s free, it’ll taste good regardless," Liu Banxia said with a laugh.

"These are the dishes compiled by our emergency center. You can filter out the duplicates yourself. In the remaining half of the day, I’ll get the duty roster sorted out for everyone. Let’s aim for the period from New Year’s Eve to the fifth day of the Spring Festival, so everyone can be in a good mood."

Zhou Qiang took the paper, glanced at it, and nodded. "No problem, they’ll all be freshly stir-fried to order. What about dumplings? Made fresh on New Year’s Eve? I’m worried we won’t be able to make enough."

"We’ll see how it goes then. Actually, everyone won’t eat that much; it’s more for the festive spirit. There probably won’t be many patients that day; many are already arranging to be discharged. I’ll also send some people over then, so we can all help out. We especially have a lot of interns in our department. If they were external residents undergoing standardized training, I wouldn’t need to be this considerate."

"Alright, I’ll definitely get it done properly for you," Zhou Qiang said seriously.

This was no laughing matter; it had to be done truly well. He also knew that during Spring Festival, everyone on duty at the hospital would have certain feelings. The emergency center was a major client of his cafeteria, so he had to manage this well.

Liu Banxia’s meal was very simple. For him now, he didn’t really care much about what he ate, as long as it filled him up. With the chicken leg from Wang Chao adding to the occasion, he ate with even more gusto.

Just as he was eating, Liu Banxia’s phone rang.

"Brother Wang, has the child’s abdominal pain flared up again?" Liu Banxia asked hurriedly after answering the call.

"Yes, it just started acting up. It’s a slight pain," Wang Chao replied.

"Wait for me, I’ll be right there."

After saying that, Liu Banxia put his remaining food down in front of Zhou Qiang, turned, and ran directly towards the emergency center.

"Just leave it there. There’s still half left; that kid definitely isn’t full," Zhou Qiang sighed.

Joking aside, they usually got along very well. It was a common occurrence for doctors in the emergency center to run off mid-meal. Sometimes, one had to think hard to recall whose tray was whose, only discarding the food after confirming they wouldn’t be back to eat.

"How’s the situation?" Liu Banxia asked, having run back.

"We just did an ultrasound; no changes. After auscultation, the bowel sounds seem a bit more frequent. You listen again," said Wang Huan.

Liu Banxia took the stethoscope and also listened carefully. It did seem to be the case; the bowel sounds were a little more frequent, but not as pronounced as he’d expected.

"Does it usually act up around this time every day?" Liu Banxia asked the child.

"Today it’s a little later. Usually, it’s a bit earlier," the child said after thinking for a moment. "And the way it hurts today isn’t like before. Um... it’s a bit milder in intensity. Although the daily pain is bearable, it’s usually stronger than this."

"Is the pain at home very punctual every day?" Liu Banxia pressed.

The child nodded. "Very punctual. Around the same time I go to my tutoring sessions."

After saying this, he glanced at his father. There was still a rift between father and son regarding the issue of whether he was lying.

Just as he turned his head back, Liu Banxia inadvertently noticed the unfinished fried noodles on the bedside table. A thought suddenly struck him.

"You had fried noodles for lunch?" Liu Banxia asked.

"Yes, but he didn’t eat much. I was upset with him, so I couldn’t eat either," the patient’s father spoke up.

"Then, try to recall carefully: does the pain always occur after eating?" Liu Banxia’s voice carried a hint of excitement.

The child thought carefully for a moment, then nodded. "It seems to be about half an hour or so after meals."

"Doctor Wang, this lunch is key! I suspect it’s chronic mesenteric ischemia. Let’s do a contrast-enhanced CT scan," Liu Banxia said.

Wang Huan nodded. "That was my oversight. I was so focused on the regular timing of the attacks that I forgot to inquire about the circumstances leading up to them."

"Doctor, is he really sick?" the patient’s father asked, somewhat nervously.

Liu Banxia nodded. "The child’s current symptoms are consistent with mesenteric ischemia. The ischemia has caused intestinal colic. From the current presentation, it’s likely that a blood vessel has narrowed. When a blood vessel narrows, it naturally affects blood flow. After we eat, the stomach requires more blood. This increased demand, coupled with reduced supply, results in ischemic pain. A contrast-enhanced CT will allow us to see more clearly which blood vessel, and which part of it, is problematic. The attacks haven’t been very frequent so far, so it probably hasn’t caused intestinal necrosis yet. The specific treatment plan will still depend on the child’s actual condition. If we’re lucky, medication to dilate the blood vessels might be sufficient. If the stenosis is severe, or if medication is ineffective, then surgery will be required to restore blood flow."

"The test, let’s do the test quickly! I’ll go pay right now," the patient’s father said, suddenly becoming very anxious.

Liu Banxia looked at the child lying on the bed. He, in contrast, seemed very relaxed, as if not scared at all.

"Not worried?" Liu Banxia asked.

The child shook his head. "Not worried. I’m in the hospital. I’ve been in pain for so long and nothing terrible happened. My intestines probably aren’t necrotic; if they were, the pain would be constant. It’s good now; otherwise, my mom would still think I was faking it."

Liu Banxia patted his hand. It seemed this misunderstanding was a greater burden to him than the physical pain of his illness. Indeed. The child clearly looked like an honest and simple boy. He was genuinely in pain, yet his parents thought he was lying; that feeling couldn’t have been good.

"Today was really a close call. If the child hadn’t persisted, I might have discharged him," Wang Huan said with feeling.

"Nonsense. You even thought of calling me for a consult; it’d be strange if you had actually let him go," Liu Banxia said with a smile.

Wang Huan chuckled too. Discharging him was only a possibility, one that would only be considered if there were truly no other recourse. After all, discharging a patient came with responsibility.

Now that they had a clear direction, the examination proceeded smoothly. After the contrast-enhanced CT was done, the results were out.

There was a stenosis in both the superior and inferior mesenteric arteries. The superior mesenteric artery had a congenital malformation, and the inferior one had a thrombus. Surgery was necessary.

DING! Mission: Was the patient lying? Completed.

Acquired 400 Experience Points, 300 Diagnostic Skill Proficiency Points, 2 Glory Points.

Current mission rating: Flawless. Acquired an additional 500 Experience Points, 500 Diagnostic Skill Proficiency Points, 5 Glory Points.