CHAPTER 179: PICKY PATIENT 179

"Liu Banxia, come to my office for a moment."

Liu Banxia was daydreaming when Zhou Shuwen, who had just walked in, called out to him. It startled him a little. Although he had always been thick-skinned, he never dared to be impudent in front of Zhou Shuwen.

"Director, is something wrong?" Liu Banxia asked somewhat uneasily after arriving at the office.

"Sit down. I heard you misdiagnosed a child yesterday? What are your thoughts on this matter?" Zhou Shuwen asked.

"I didn’t expect you to have heard about it already. I’ll be more careful in the future," Liu Banxia quickly responded.

"Just being careful is enough? Don’t you feel embarrassed?" Zhou Shuwen glanced at him.

Liu Banxia grinned. "At first, I felt quite embarrassed, but then everyone else consoled me."

"It’s good you didn’t try to make excuses, like saying the child’s nasal endoscopy also revealed polyps that might indicate sinus cancer," Zhou Shuwen smiled and nodded.

"Ah... Director, you knew about that too?" Liu Banxia was quite taken aback.

"Nonsense. Otherwise, what do you think I’m here for as director? What use would I be? You might as well put a cat in this seat, wouldn’t that be better?" Zhou Shuwen glared at him.

"Well... um... I thought you were going to criticize me. Say I was too reckless and deserved it," Liu Banxia replied, somewhat sheepishly.

He actually had that thought. Zhou Shuwen had always been decisive and had no patience for errors. Yesterday’s incident truly made him lose face. He’d really messed up.

"As doctors, we are sometimes allowed to make mistakes. Even instruments can malfunction in certain specific situations," Zhou Shuwen said.

"But some errors are absolutely unforgivable. Our work is tiring and complicated, yet it concerns the patients’ health."

"In our medical practice, we encounter all sorts of patients, and each requires a different approach. For example, your method of always trying to keep patients in good spirits, always being cheerful and smiling—I won’t comment on that."

Liu Banxia felt somewhat embarrassed. He thought Zhou Shuwen was busy every day and had no idea he even knew these small details.

"Aside from those errors of principle, if you make a mistake, you make a mistake. But that doesn’t mean these seemingly minor errors can be made carelessly. We need to learn from these mistakes so we can grow."

"This is something you need to pay attention to, and also something you’ll need to consider when guiding resident doctors in the future. The list of attending physicians to be reassigned to the Emergency Department will be finalized in a day or two, and some of them will arrive first."

"Soon after, the resident doctors will officially be on duty, and you’ll be their overall supervisor. How they are assigned and assessed will be for you to figure out. Alright, you can go. Nothing else."

Liu Banxia walked out feeling a bit dejected. He felt the pressure again, and it was overwhelming.

Zhou Shuwen had a "dual identity"—he was his teacher and also his superior. Just now, he had played both roles to perfection.

The earlier part was concern and guidance; that was the teacher’s role. But after showing concern, he’d piled a heap of responsibilities onto him.

He’d already been somewhat concerned before that his role as chief resident granted him a bit too much authority. Now? This pressure stood right in front of him.

"What’s wrong? Did Director Zhou criticize you?" Wei Yuan asked with a laugh.

"Sigh, no criticism, he even encouraged me. But there’s so much happening in the Emergency Department, I don’t know what to do," Liu Banxia said with a bitter smile.

Wei Yuan chuckled. "Well, you can figure it out yourself. I can’t help you."

Liu Banxia looked at him helplessly. Worrying wouldn’t help. Fortunately, even with the shift rotations, not too many people would be assigned all at once this year.

This was because the Second Hospital’s emergency department had a very weak foundation. Trying to establish a full trauma emergency center immediately would be quite strenuous. For now, they would operate on a smaller scale, and once they gained experience, they could expand directly.

At that moment, he saw Lu Gang walk out of the corridor. Although there was a smile on his face, it was a bitter one.

"Did the results come back?" Liu Banxia asked.

Lu Gang nodded. "Stage 2. He needs chemotherapy. He can still live for some time."

DING! Strange Wound task completed.

Earned 1,000 experience points, 300 points in Diagnosis Skill proficiency.

This task evaluation is Perfect grade, earned 1,000 experience points, 500 points in Diagnosis Skill proficiency, and 10 Glory Points.

Looking at the system notifications, Liu Banxia didn’t feel the slightest bit of joy. Compared to the experience and rewards from tasks at this stage, this one was exceptionally generous.

"Dr. Liu, don’t worry. I will definitely fight to live," Lu Gang said, turning to comfort him.

"I can manage the treatment costs for now. I don’t need imported drugs; domestic ones will be fine. Health insurance will reimburse some of it, and the commercial insurance I bought before will provide an additional 200,000. That should be enough."

"Keep fighting." Liu Banxia patted him firmly on the shoulder.

"Um-hum, I’ll head off first. I need to eat well for a few days. I’ve heard that once chemotherapy starts, people really suffer." Lu Gang waved at him and left the Emergency Department with a smile.

Liu Banxia scratched his head, his feelings somewhat mixed.

"What are you thinking about?" asked Liang Xiaolin, who was on duty.

"That patient who was bitten by a dog, the one with stage 2 cancer... It’s a bit troubling. A patient with a swollen ankle just came in; I’ll see them," Liu Banxia replied casually.

A somewhat chubby young man limped in, wearing a slipper on his left foot. His ankle was extremely swollen.

"How did this happen?" Liu Banxia asked.

"I missed a step coming down the stairs yesterday," the young man said with a bitter smile.

"At first, it wasn’t so swollen, just a bit painful. I took some ibuprofen, but when I woke up, it was this swollen. Do I need to get an X-ray?"

Liu Banxia nodded. "With swelling like this, an X-ray is definitely necessary. There might be a fracture. Your complexion isn’t very good. Why are you sweating so much? Do you have any other discomfort? Any history of diabetes, high blood pressure, or other illnesses?"

"I’m on a diet to lose weight and I exercise every day. I haven’t had any other illnesses," the young man said.

"Sigh... you’ve really gone all out. Does it still hurt after taking ibuprofen?" Liu Banxia asked, lightly touching the ankle.

The young man nodded. "I also have chronic toothaches. Could I have developed a tolerance to ibuprofen from taking too much?"

"How have you been taking it?" Liu Banxia asked.

"I just take it whenever I have a toothache. Sometimes my muscles ache after running, so I take it then too. Um... ibuprofen isn’t addictive, is it?" the young man asked hesitantly.

"All medicines have side effects. You’ve practically been taking it daily, haven’t you?" Liu Banxia said. "You need to do things within your body’s limits. It’s quite possible that because your diet and exercise have put excessive strain on your body, and you haven’t been getting enough nutrients, your bones have become this brittle."

"It’s fine to lose weight, but it must be done while ensuring your health. Otherwise, even if you slim down but ruin your health, what’s the point? Let’s do a blood test to check your vitamin levels and then get an X-ray."

"Otherwise, at your young age, there’s a high chance you could have avoided this. Once the test results are out, we’ll discuss how to proceed. Xu Dan, take him to handle the paperwork."

Although he said that, he greatly admired the young man’s willpower. He had seen many people who wanted to lose weight, but not many could truly control what they ate.

But admiration was one thing; this reckless approach to weight loss was definitely not the right way.

"Dr. Liu, there’s a patient here who needs a consultation," Wei Yuan called out at that moment.

"What’s the situation? With your level of skill, you still need me?" Liu Banxia asked as he walked over, glancing at the patient’s medical record.

"The situation is a bit complicated," Wei Yuan said. "He’s a 32-year-old male who came in with acute abdominal pain. His blood pressure was a bit high just now. He hasn’t had a bowel movement in three days. A simple physical exam suggests he likely has an intestinal obstruction, but he refuses any instrumental examinations."

Liu Banxia was stunned. Now he understood why he had been called for a consultation: another patient refusing instrumental examinations.

"If it really is an intestinal obstruction, refusing instrumental examinations could endanger your life," Liu Banxia said to the patient. "Are you worried about X-ray radiation, or something else? We need to determine the location of the obstruction to proceed with the diagnosis."

"Doctor, can’t you just prescribe me some laxatives? If I pass it, won’t that be fine?" the patient on the bed asked, glancing towards Qing Kewa, who had followed them in.

"It’s not that simple," Liu Banxia said. "We need to see the actual state of the obstruction. It’s been three days; that’s not a short time. If intestinal necrosis has occurred, we can only resort to open abdominal surgery."

"X-rays do have radiation, but it’s not like we do them every day. Without instrumental examinations, how can we determine which specific segment of our long intestines is affected?"

"I just don’t want an X-ray. You guys think of something else," the patient said, shaking his head, still very resolute.

"Then let’s do a CT scan," Liu Banxia suggested. "CT scans have much less radiation than X-rays. It just costs more and takes a bit longer."

To his surprise, the patient shook his head firmly again. "Didn’t this doctor just mention an enema or something? Can’t you just do that? But I want a male doctor to perform it."

Liu Banxia was exasperated. This was the first time he’d met such a picky patient. What does he think this place is? Being so choosy.

"I need to explain something to you," Liu Banxia said very seriously. "Without a clear diagnosis, we cannot perform any treatment. Improper treatment could worsen your condition."

"And now, because you’re so uncooperative, we can’t even determine the cause. If it truly is an intestinal obstruction, every bit of delay increases the risk of intestinal necrosis."

"You also need to think from our perspective. Without a clear indication, who would dare to haphazardly give you an enema? Right? There are responsibilities involved."

All he could do was persuade with his utmost effort. If the patient remained this insistent, he would have no choice but to have him sign an informed consent form.