The Enhanced Doctor-Chapter 522 Demonstrating by Action Teaching (Added 671112 for emptiness, loneliness, and cold 8/8)
"What are you all doing crowded around here? Have you got nothing else to do?"
After helping to triage a few patients for the internal medicine department, Liu Banxia stepped outside.
"Teacher Liu, how did you diagnose that? The patient has been diagnosed with several capillary thromboses in the brain and is currently undergoing thrombolytic therapy," Miao Rui said.
*Ding! Consultation complete.*
*You’ve earned 100 experience points, 50 diagnostic skill proficiency points, and 5 Glory Points.*
"Doctor Wang, please enlighten them," Liu Banxia said with a smile.
Wang Chao shook his head. "Never mind them; even I’ve been pondering this for a while and haven’t figured it out. The indicators are too few. You were so certain; it couldn’t have been just to be absolutely safe."
"Seriously? Did all of you overlook hypertension?" Liu Banxia asked, surprised.
"But Teacher Liu, patients with vertigo symptoms often have hypertension too," Miao Rui said.
"Then recall the patient’s condition carefully. If you’re not careful, you’ll owe me pig trotters for lunch," Liu Banxia said.
"Adding two would be fine! I’ve also thought it over carefully several times," Miao Rui said with a wry smile. "The patient thought he had an otolith issue, so he came to see a doctor. However, his only symptoms were vertigo, a flushed face, and hypertension. There were absolutely no other symptoms that might indicate a stroke."
"That just shows you weren’t careful. What about before he came to the hospital?" Liu Banxia asked.
"Before the hospital? Wasn’t it just that he thought his otolithiasis was acting up?" Miao Rui said.
"That just shows you weren’t careful," Liu Banxia said with a smile.
Miao Rui frowned, thinking hard. What could he have missed?
"You silly goose, it was carsickness," Liu Banxia said with a laugh. "Many people get carsick due to factors like bumps, swaying, smells, or spinning. However, whether it’s carsickness, seasickness, airsickness, or even space sickness, they all share a very distinct characteristic."
"These symptoms usually disappear within a few minutes or a few hours, and the person feels normal again. The elderly gentleman said he had been dizzy for over two days. Is that normal?"
"So when the elderly gentleman said that, I felt it wasn’t just simple otolithiasis. Because otolithiasis also has its own characteristics; it’s mostly triggered by head movements."
"If you know you have this condition, even without a doctor’s explicit instructions, you wouldn’t just shake your head for fun, right? You’d definitely be careful in your daily life. Even if the otoconia haven’t repositioned, and it occurs frequently, it wouldn’t torment the elderly gentleman to this extent."
Everyone carefully considered Liu Banxia’s words and found them very plausible.
Based on some of the patient’s descriptions and presentations, Liu Banxia grasped the key point and developed his diagnosis. This was the meticulousness Liu Banxia had just emphasized twice.
"President Liu, I admit this could certainly be one point of speculation. But to connect it to a stroke, isn’t that still a bit tenuous?" Wang Chao said. "Many patients with vertigo exhibit various symptoms. Can’t this also be classified under vertigo for now?"
Liu Banxia nodded. "Indeed it can. But combining the patient’s age, nystagmus, hyperemia, blood pressure, and flushed face, we could already make a bold inference."
"Every patient’s presentation will differ. The elderly gentleman probably used to work in the fields often. He has many wrinkles on his face, so we couldn’t determine if there were clear signs of paralysis."
"Furthermore, the patient’s entire period of illness was quite long. It means the old man only came to the hospital because he truly couldn’t bear it any longer; otherwise, he definitely wouldn’t have come."
"Of course, I wasn’t 100% certain at the time; it was just a strong personal inclination. Checking with a brain CT scan wouldn’t cause any harm, especially at his age. Miao Rui, my little classmate, the pig trotters, okay?"
"Teacher Liu, I’m more than willing to add those pig trotters," Miao Rui said wholeheartedly.
This was a diagnostic process on two different levels. It was like cooking: Miao Rui could only prepare a dish once the ingredients were prepped by someone else. And Liu Banxia? He was like someone who started planning the dish the moment he saw the raw ingredients.
You could say Liu Banxia also had an element of luck in his guess today, but isn’t that what treating patients is sometimes like? Sometimes, you have to rely on such ’guesses’ to quickly diagnose a patient.
Fortunately, this time the patient’s blockage was still in small blood vessels. What if it had been a major vessel? Any further delay, and they might not have even had a chance to save him.
For a patient of this age, a stroke can actually occur even during normal daily life.
"Given the current situation, I think our lovely Teacher Wang can cover the shift this afternoon, with the rest of you interns assisting. Since Miao Rui is treating me to pig trotters for lunch, he can accompany me first," Liu Banxia said smilingly.
Wang Chao rolled his eyes, while the interns chuckled.
Miao Rui didn’t feel exploited at all for having to treat him to pig trotters; on the contrary, he was quite happy.
The process of learning medicine is indeed a process of accumulation. Once you’ve experienced a certain illness, it leaves a deep impression in your memory.
Merely reading books isn’t enough. Although you memorize things, it’s just memorization. Whether you can apply it flexibly is another matter entirely.
It’s like how people nowadays are used to using GPS when driving. They do whatever the GPS says, and they’ll drive straight ahead even if there’s a pit in front of them.
But what about the old-timer drivers from back then? There was no GPS. They all used maps to find their way. They might travel a particular road only once in their lifetime, but because they found it themselves, they might not forget it even after several years.
"Teacher Liu, how do you manage to be so meticulous? Whenever you explain something, it feels like everything suddenly becomes clear. But when it’s my turn, it’s a different story."
On the way to the cafeteria, Miao Rui asked curiously.
"There’s no special trick to it," Liu Banxia said with a smile. "Just think more and experience more, and you’ll be fine."
"Take today’s patient, for example. I had another speculation, which I didn’t mention because it was pure guesswork. Perhaps because he was going to his child’s home for the New Year and was overly excited, the elderly gentleman already had mild stroke symptoms."
"It’s just that, in the elderly gentleman’s perception, this felt similar to carsickness. After all, the dizziness from insufficient blood supply to the brain isn’t much different from the dizziness of carsickness."
"But there’s no way to verify this at present, so I didn’t mention it. Too much time has passed. It’s also possible that the carsickness caused otolithiasis, and the vertigo from otolithiasis then led to the stroke."
"We can’t perfectly deduce the entire process for every illness. When diagnosing, we rely on our experience and intuition. Even if we’re berated by patients for ordering too many tests and called quacks, I think it’s worth it."
Miao Rui nodded, not thinking for a moment that Liu Banxia’s words were about admitting weakness.
In emergency situations, sometimes you genuinely need such experience and "intuition."
After all, not every emergency patient allows you the time for a comprehensive examination. Even if you conduct one, some complex, intertwined conditions might still prevent a definitive diagnosis.
"Oh, President Liu, on duty? What do you feel like eating? Today, it’s on me, your big brother," Zhou Qiang greeted him warmly upon seeing Liu Banxia enter.
"What’s going on? Why are you so cheerful?" Liu Banxia asked curiously.
"How can I not be? Everyone says I’m doing a conscientious job with this cafeteria, so I have to be happy," Zhou Qiang said. "I’ve been meaning to tell you, what you said when the Chief Director came over was incredibly helpful. You really did me a huge favor, so this meal must be on me."
"Manager Zhou, you can treat him next time. I have to treat Teacher Liu to this meal," Miao Rui said with a laugh. "Do you have pig trotters? I need to get Teacher Liu an extra serving."
"Good heavens, you make it sound like I’m taking bribes," Liu Banxia joked. "Old Zhou can treat this meal, and you can treat me to pig trotters next time. If I were to accept bribes, I’d consolidate them into one day; the offense might seem smaller that way."
Since he put it that way, the matter was settled.
It was just a meal; how much could it cost in the cafeteria? Even if he ate a lot, it would only be about ten or so yuan, a far cry from bribery.
"Seize the upcoming rotation opportunities in the ICU and pediatrics department. Don’t think of them as purgatory or an ordeal. Those who can endure it there will find it much easier when they’re back to seeing patients," Liu Banxia said after they had gotten their food.
"Our profession as doctors is actually a craft. Craftsmen value enduring hardship. The more hardship you endure, the more solid your skills will be in the future."
"Others are always complaining about how high-risk this profession is, or how stressful that one is, or about our long working hours. Let them come to the hospital and experience it for themselves. A few shifts would be enough to see what they’d have to say then."
"If you all lacked talent or the willingness to endure hardship, I wouldn’t be saying any of this. Actually, it really has nothing to do with me. No matter how I guide you, my salary won’t be docked, nor will I get a bonus."
"The director put it well: we must be responsible. Since you’ve come to the Second Hospital’s emergency center, you must leave as qualified emergency doctors."
Miao Rui nodded and began to eat his lunch with gusto.
He was deeply moved. Liu Banxia never explicitly told them they *had* to do things a certain way; he always led by example. Today’s patient was a prime teaching case, and it had a profound impact on him. It could even be said that he had never deeply contemplated his career as a doctor before. Having witnessed so many of Liu Banxia’s brilliant moments, it would be a lie to say he wasn’t envious. Yet, he had never imagined that he, too, could one day be as formidable as Liu Banxia. Today’s experience made him realize that Teacher Liu could make such diagnoses because of his meticulousness and his thorough thinking. He might not possess Teacher Liu’s hands-on skills, but surely he could strive to be more diligent in diagnosis, couldn’t he?
"Teacher Liu, bad news! Hurry, come and see! A patient died under Teacher Wang’s care, and now they’re raising hell!"
As they were eating, Huang Bo rushed over, his face etched with panic.
Hearing this, Liu Banxia dropped his chopsticks and bolted out.
