"I took it! The test results are similar to what you have here."
The patient hesitated before answering.
"Have you brought the film?"
"I have to ask my son!"
The patient is obviously putting off.
When Li Jingsheng saw the patient getting up, he was holding the lumbosacral position with difficulty with his left hand. His expression was slightly painful, and he secretly gritted his teeth and his cheeks were bulging.
"Slow down, slow down!"
He quickly ran over and helped the patient.
After leaving the medical technology room, Li Jingsheng felt more uneasy.
He was very happy to receive a job of manual bone reduction early in the morning. But we cannot be like a fish, seeing the erbium but not the hook, seeing the profit but not the harm.
He could sense a hint of malice while talking to this patient.
I can’t put it into words, it’s just a kind of keen professional judgment after dealing with all kinds of patients for many times.
More than 99.9% of patients will have a favorable impression of the doctor when they go to see a doctor. It can even be said to be awe and flattery.
Because they need doctors to relieve their pain.
The two parties themselves also have a relationship of cooperation and mutual trust.
In ancient times, there were six types of doctors who did not practice medicine. The first one listed was those who did not believe in medicine and did not treat people.
A patient who does not trust the doctor cannot be cured.
Li Jingsheng looked at the patient subconsciously. His face was dark yellow and slightly black, and the bags under his eyes were so severe that they were half as big as a baby's fist.
The eyes are slightly cloudy and yellow.
His hair was slightly disheveled and his beard was stubbled. It must have been two days since he had shaved.
"Hey, hey, wait, it's my clothes."
When going out, because Li Jingsheng supported the patient, the width was not enough when passing the door frame. The patient's clothes accidentally got caught on the edge of the door lock.
The patient stopped immediately, turned slightly and used his right hand to get the clothes that were caught.
At this moment, Li Jingsheng suddenly discovered a small bruise and a small red dot on the patient's right wrist.
This is the needle hole left after intravenous drip.
The small piece of bruise and edema was caused by the penetration of the drug after the infusion.
His eyes narrowed slightly.
It is difficult to achieve this phenomenon with only one or two infusions. It usually requires an indwelling needle and multiple infusions before it appears.
Of course, it is not ruled out that some young nurses may not have good acupuncture skills, causing the liquid to become clogged or even injuring blood vessels.
No matter which case, it means that the patient has received infusion in other places, and the time is very recent.
This can be eliminated automatically in two or three days at most, or even as quickly as more than a day.
Li Jingsheng remained calm this time because the man was about fifty years old. When a man of this age is cunning, he would simply cheat someone to death without paying for his life. It was too difficult to get anything out of his mouth.
Especially if the other party deliberately wants to hide something.
I couldn't ask any more questions.
Li Jingsheng helped the patient back to the consulting table outside and deliberately observed the man's sitting posture secretly.
When he sat down, the man's wife and son were supporting him on the left and right, and the man's right leg was slightly stiff. Li Jingsheng discovered this phenomenon in the medical technology room.
If the hip joint is injured, it should not cause the knee to be unable to bend!
Thinking of the traces left by the infusion on the patient's hands, the flickering words in the interview, and many doubts, Li Jingsheng has decided to give up this business.
His small clinic has just developed a little better, and there is some hope. If he takes on a problematic job, it will be considered good until liberation.
I'm afraid that his small clinic will be shut down directly.
"Please show me the film your father took in the hospital."
Li Jingsheng said directly to the patient's son.
The patient's son looked at his father.
"Dad, didn't you take the films taken at the People's Hospital?"
This son is so powerful that he cheats his father!
In one sentence, a lot of information was revealed to Li Jingsheng.
"Oh...look at my memory. I don't know if I forgot it at home or left it in the hospital. Dr. Li, the film taken here must be the same! I am in severe pain and it is difficult to move. Do you want to If you don’t treat me first, I’ll come over next time to change the dressing or something, and then I’ll show it to you.”
The patient said something softly, urging Li Jingsheng to treat him quickly.
I really thought Li Jingsheng was young and easy to fool.
"Don't rush into treatment. At least we need to figure out the cause."
"Look, there are several patients waiting behind me! Give me some medicine first, to relieve the pain! Besides, I praise you for your superb medical skills. A minor injury like mine is not worth it to you. Isn’t the medicine curing the disease?”
the patient urged.
The more anxious he was, the more vigilant Li Jingsheng became.
When he first became a resident physician at the First Hospital, an older deputy chief physician in the group said something that still remains fresh in his memory.
The patient had been hospitalized for nearly two months and had advanced lung cancer.
The doctors and nurses advised him to take some painkillers at home and there was no need to waste both life and money.
Although the family members did not mention it explicitly, they also had that intention.
After all, the daily cost of living in a hospital is not a small amount.
The patient never wanted to be discharged from the hospital.
The older deputy chief physician instructed the doctors in the team and department nurses to change and administer the medicine to the patient. A senior attending physician or nurse in charge must be present at the scene.
Li Jingsheng once entered the ward, and the patient waved to him weakly.
He said it was painful to breathe and he was still a little breathless, so he asked Li Jingsheng to give him some painkillers and anti-asthmatic medicines.
At that time, the attending physician above happened to go to other departments for consultation. Li Jingsheng thought it was not a big deal, so he prescribed some painkillers to the patient. However, antiasthmatic drugs involve relatively high levels of efficacy and pharmacokinetics, so he did not dare to take the risk.
Later, the deputy chief physician found out about this and called Li Jingsheng to the office and cursed him in front of everyone.
That's really the kind of person who doesn't show any mercy at all.
After scolding him, he looked at Li Jingsheng and said earnestly, "Do you think the patient who insists on being hospitalized all the time is waiting for us to create a medical miracle? Maybe he is waiting for an accident."
After hearing this, Li Jingsheng later entered the ward, and his hair stood up every time he saw the patient.
If the patient comes to him to prescribe medicine or something, he will do whatever he can to prescribe it.
If it doesn't work, ask the attending physician to handle it.
After doing this several times, the patient stopped looking for him.
Now, looking at this patient with a dislocated hip joint, he felt a chill that seemed familiar to him.
It was hard to explain, but this patient looked very respectful and trusting to him. When talking to him, he would try his best to put on a smile on his face, but it still made Li Jingsheng feel a trace of inexplicable malice.
"Okay, you guys sit over there and rest for a while. I'm not good at treating this kind of hip dislocation, and you trust me so much. I'll try to ask a doctor from a big hospital to come over and help."
Li Jingsheng decided to ask Dr. Xu to come and help.
Dr. Xu should not be working on Sunday.
The patient did not object this time.
He also saw that there was no point in insisting.
Li Jingsheng called Dr. Xu on the spot. To be honest, he had no idea.
Dr. Xu has a weird temper and may not come.
"Xiao Li, what's the matter?"
As soon as the call was connected, the person asked.
"I have a patient here with a hip injury. Bone palpation and X-ray examination all show that the joint is slightly misaligned, but I am not sure. Can you please come over and help with consultation?"
There was silence on the other end of the phone for two or three seconds.
"Do you suspect a fracture or other problem?"
Dr. Xu deliberately lowered his voice.
"Others!"
Li Jingsheng naturally couldn't say it clearly in front of the patients and their families.
"Okay, I'll be there in half an hour."
After saying that, Dr. Xu hung up the phone directly.
The teacher rushed over to help in a short while, and Li Jingsheng felt a lot more at ease.
He wasted no time attending to other patients.
Yesterday's celebration of the first anniversary of the clinic was somewhat effective. Seven patients were admitted in the morning, and all of them were new patients. This kind of grand event had never happened even that time in the Metropolis Daily.
A young man with dark circles under his eyes and messy hair sat over, yawned profusely and said, "Doctor, I felt dizzy when I got up this morning. I have no strength and feel a little nauseous. I suspect I have a cold. Please help me prescribe some medicine."
Li Jingsheng measured the man's temperature and found that he had a low fever of 37.2 degrees.
In clinical diagnosis, he especially hates a body temperature of around 37 degrees, because it is very unfriendly to diagnosis.
I don't think I have a fever, but my body temperature is higher than normal.
Let’s talk about having a fever, it’s just up to the standard of low fever.
And if the illness has just started and then a low fever occurs, it often indicates that the condition is not yet obvious.
It’s not easy to use medication at this time.
Western medicine focuses on symptomatic treatment.
If there are any symptoms, help the patient relieve the symptoms.
Low-grade fever is generally not treated clinically. Letting it burn is also a sign that the immune system is beginning to fight the disease, so there is no need to suppress it.
But the patient will feel uncomfortable!
If the fever lasts for a little longer, the patient will feel weak and uncomfortable.
Competition among small clinics is fierce. If you don’t treat low-grade fever with medicine, patients will feel that the effect is not significant and will not come next time.
Therefore, Li Jingsheng hates low-grade fever.
"How much do you weigh? Have you weighed you?"
Li Jingsheng found that the patient's face was slightly fat, but it didn't look natural.
So I asked casually.
"It looks like 62 kilograms! I just weighed it last month."
"You should be close to 1.8 meters tall, right?"
"176 centimeters."
"Let me see your face."
After Li Jingsheng finished speaking, he pressed the patient's face and found that after pressing down and letting go, the depression would take a long time to heal.
He immediately realized that this patient should have facial edema.
"Did you relieve yourself this morning?"
"It's strange to say that I usually have the habit of urinating in the morning. I feel like I've peeed a lot less in the past two days, and I didn't relieve myself this morning." The man looked about 24 or 5 years old. If he had gone to college, he would have just finished urinating. Not long after I entered social work.
"Do you have a regular daily routine?"
Li Jingsheng continued to consult.
"It's not bad, I just like playing online games. Once I get up, I play with my teammates all night long."
"Do you usually drink a lot of water?"
"I don't usually drink water. I like to drink Sprite and beer. Especially Sprite, I usually drink it as water."
The man's answer already made Li Jingsheng feel that the problem was very serious.
"Come on, let me see your calves! Just roll up your trouser legs."
Li Jingsheng said to this young man.
The young man did as he was told.
"Doctor, I have a cold, why do I need to look at my legs?"
The tone and expression of his questioning made him suspect that he was seeing a quack doctor or a rogue doctor in the clinic.
Li Jingsheng did not answer immediately.
Instead, he carefully inspected the patient's lower legs and found that there was also edema.
"It's possible that your illness is not a cold. Are you a local or a migrant worker?"
Li Jingsheng already highly suspected that the young man was seriously ill.
"I study in Linjiang City, and I have several relatives living here. Just give me some cold medicine. I won't treat other diseases."
The young man just didn't say it clearly, you, a rogue clinic doctor, don't try to trick me into treating non-existent diseases.
Other waiting patients and family members watched all this.
Even a few customers buying medicine over there looked over.
Many people didn't know much about Sunshine Clinic, and they looked at Li Jingsheng with doubts in their eyes.
They wanted to see how Li Jingsheng was going to fool this young man.
"I can't cure your disease here. Personally, I don't think it's a cold. I suggest you contact your family immediately and go to a large hospital for a kidney function test. Also, stop drinking Sprite as water. This behavior is very harmful. Kidneys. Staying up late can also damage your kidneys. You are still so young, so you must not delay. Trust me, contact your family and go to a big hospital for a checkup."
Li Jingsheng said with a serious face.
It's okay for patients to question him or even attack him.
But as a doctor, you must let your patients understand the seriousness of their condition.
This young man is still so young, it would be a pity if his illness was delayed.
Doctors cannot make any decisions for patients and can only give advice.
"It's not that serious, right? Are you trying to scare me?"
The young man obviously didn't believe it yet.
"Why am I scaring you? Go to a big hospital for a check-up quickly, and never drink carbonated drinks as water again in the future."
Li Jingsheng almost laughed out loud.
"Young man, you are right to listen to Dr. Li. Not only is Dr. Li superb in medical skills, but he also has excellent medical ethics. He will not harm you."
The wife of the old man who treated pustules helped Li Jingsheng speak.
Some patients just don't understand Li Jingsheng's personality, so they misunderstand his good intentions.
"Doctor Li, this is for your own good! If I really want to rip you off, why should I let you go to a big hospital for treatment?"
"Just listen to the doctor."
Others also tried to persuade the young man.
Finally, the young man agreed.
"Okay then! I'll go to the hospital for a checkup first, and if I have any questions, I'll call my parents."
Like most young people working hard outside, they report good things to their parents but not bad things.
It’s not a big deal, and I don’t want to worry my parents.
Li Jingsheng breathed a sigh of relief when he saw this young man listening to the advice.
However, kidney failure is a Pandora's box. Once opened, it cannot be stopped.
According to Li Jingsheng's professional knowledge, this young man's kidney failure has progressed to at least the second stage, and may even be worse. In the advanced stage, dialysis is basically the only way to save life.
If you want to transplant a kidney, one is that it is difficult to find a kidney source, and the other is that the high cost is enough to discourage many families.
Even if the kidney transplant is successful, rejection drugs will still need to be taken for life.
It is really sad that this young man suffered from kidney failure at such a young age.
On the contrary, it was the 'glamorous man' who was pestering Tang Ping. Although this man might have symptoms of kidney deficiency, it was not a big problem.
Most middle-aged men have kidney deficiency problems, but the degree is different.
Kidney deficiency is not the same as kidney failure. They are two completely different diseases.
The two patients in a row had more than a simple ailment, which made Li Jingsheng extremely cautious.
It is a good thing that business is improving, but the crisis has also increased.
Among the patients he receives, he may be shocked at any time.
Fortunately, the next few patients were not difficult to deal with. The most serious one had severe tonsillitis, so they directly prescribed medicine and asked Tang Ping to give her an intravenous drip.
Less than half an hour later, Dr. Xu arrived in a hurry.
"Teacher! You are here!"
Li Jingsheng was very happy to see Dr. Xu arriving and felt confident in his heart.
"Where is the patient?"
"That's the gentleman."
Li Jingsheng introduced both parties.
"Show me the film you took!"
Dr. Xu asked for the X-ray film and looked at it. Two muscles on his face twitched and he silently returned the film to the family.
This was probably the first time he had seen an X-ray with such poor clarity.
But he could understand Li Jingsheng's difficulty.
For a small clinic, it is very good to have X-ray testing equipment.
Even among the most profitable dental clinics, many purchased X-ray testing equipment only after they made money. Prior to this, patients who encountered tooth extractions had to do so blindly.
"You might have to take off your outer pants and give him a check."
Doctor Xu is preparing to perform the bone touching technique.
When the bone palpation technique is practiced to a certain level, it can even be more accurate than a CT scan.
Li Jingsheng was going to explain the situation before the teacher touched the bones. There are many things that are inconvenient to say in front of family members and patients.
Then you can only create opportunities yourself.
"There is a female patient in the infusion room undergoing infusion. I'm afraid it's not convenient. Teacher, could you come with me to see if the bed in the treatment room can be used?"
Li Jingsheng said to Dr. Xu.
Dr. Xu's weird temper does not mean that he is not smart.
He understood Li Jingsheng's meaning almost instantly.
The two entered the treatment room.
"If you have anything to say, just say it quickly!"
Doctor Xu took the initiative to speak.
"This patient said that he had a fall, which made it difficult to walk. When I felt his bones, it was true that there was a certain degree of dislocation in the hip joint, but I doubted that he had some big problem and was not telling the truth. I saw it inadvertently before There are traces of intravenous infusion on his left hand, and the time should be very recent. I am afraid of falling into a trap, but I am also worried that I am too worried, so I want to ask you to come and check. If you are not sure, then I would rather If you kill someone wrong, don’t let him go and push him away directly.”
Li Jingsheng quickly talked about his doubts.
He must be responsible for the entire clinic. The risks are too high and uncontrollable, so he cannot play with fire.
"knew!"
Dr. Xu nodded, walked out of the treatment room and waved to the patient.
"Come here, the bed in here can be used."
The family members supported the patient and slowly walked into the treatment room.
Dr. Xu asked the patient to lie down on the bed, take off his outer trousers, and began to feel the patient's bones.
In terms of strength, Dr. Xu's bone touching skills are definitely much better than Li Jingsheng's.
I saw Dr. Xu touching the patient's bones with a serious expression.
The family members were watching.
Li Jingsheng naturally followed and studied.
Even though his bone-touching technique has reached a proficient level, there is still a lot of room for improvement. Many of the advanced skills still need to be understood by him.
"Lie on your left side."
Dr. Xu seemed to have made some discoveries. He assisted the patient while instructing him to lie on his left side.
"The knee of your right leg wasn't injured, right?"
"No. At that time, I just fell on my butt and sat on the ground. The height was not high, just the height of a step ladder."
The patient was quite honest when speaking in front of Dr. Xu.
The doctor is old and did not expect to have this advantage. It can naturally suppress the patient's thoughts of lying.
(End of chapter)
