The life of the poor is cheap. This is a very cruel reality.
The woman was reluctant to spend money, but she felt sorry for her child, so she only bought a piece of bread for her child to eat. Even if the child eats leftovers, she would rather go hungry than eat them.
"If the child is successfully admitted to the hospital later, you still need to eat something. The child still needs you to accompany him. If he doesn't eat and falls ill, no one will take care of the child."
Li Jingsheng said to her.
"Come, let me check on the child."
He first checked the child's breathing, which sounded obviously heavy and short.
Not to mention his complexion, it looked completely sick.
"Is the child's breathing always so heavy?"
Li Jingsheng asked.
"I asked about it, and she said she has always had heavy breathing, but it's just more serious now."
Lian Tao answered on the woman's behalf.
Normally, children shouldn't be breathing so heavily.
It is possible to breathe so heavily only after doing strenuous exercise.
First, check the child's nostrils to see if there are any nasal polyps or the like.
The lights in the square were very dim, and Li Jingsheng had to use the flashlight function of his mobile phone as a temporary lighting.
No abnormalities were found in the nostrils.
"Hey, why are the blood vessels in this neck so thick?"
After Li Jingsheng looked at his nose, he naturally looked at his neck.
As a result, one can see at a glance that the blood vessels on the side of the child's neck are highly bulging. Like an angry person, his chest is red, his neck is thick, and his blood vessels are bulging.
At first I thought that the blood vessels in the neck were so obvious because the child was leaning on his mother's shoulder with his neck sideways.
After the child's head was straightened, the blood vessels were still bulging.
This time Li Jingsheng was sure that the child's neck veins were definitely abnormal.
"Brother Lian Tao, her jugular veins are dilated. I have never seen this kind of situation. Have you seen it?"
"I've seen it before. Many cases like this are caused by narrowing of blood vessels."
Lian Tao was well-informed. After coming over to take a closer look, he had already begun to think again.
Li Jingsheng's cardiovascular diagnosis and thoracic diagnosis have reached a proficient level, but when it comes to diagnosing such a case that he has never encountered before, it seems a little inadequate.
He had accumulated a lot of health points recently, which he originally planned to use to increase his level experience.
I have been stuck as a junior attending physician for some time.
At present, his level experience has been raised to 1674.5\/2000, a junior attending physician.
Because he performed several surgeries in the operating room, worked alone in the manual reduction clinic, and the number of patients in the Sunshine Clinic was also considerable, his level experience was only over 300 points short of being promoted before he knew it. On to the next level.
His current health balance is 711 points.
Not to mention rich, at least it is quite considerable.
It feels like this little girl's jugular venous distension should be related to the lungs or pericardium.
Should I upgrade my diagnostic skills in thoracic surgery or cardiovascular medicine at this moment? This is a difficult question.
Thoracic surgery basically does not involve the pericardium.
Li Jingsheng gritted his teeth and finally chose to upgrade to cardiovascular medicine diagnosis.
After spending 387 health points, it successfully raised its proficiency to Xiao Cheng.
Diagnosis of cardiovascular medicine: 500/1000.
At this moment, he already has the diagnostic level of cardiovascular medicine at the senior attending level.
There are 324 health points left.
With two more points, you can upgrade your doctor level by one level.
It's not difficult at all.
As long as the cause of the child's illness is diagnosed, at least 1 point of health can be gained.
In fact, in difficult cases like this, the health bonus has never been stingy.
At least 10 points.
Li Jingsheng tried to take the child's film, and then made a diagnosis based on the child's actual condition.
If the jugular vein is really stenotic, if you want to create such a dilated effect, it must be narrow at the top and wide at the bottom.
With the diagnosis of cardiovascular medicine at the junior level, many problems can be easily solved.
Becoming more familiar with various causes of cardiovascular disease.
At the time of diagnosis, it was like a veteran attending who had experienced many battles and became more knowledgeable.
The medical knowledge in this area is well integrated from the related disease cases that I have seen in daily life, and can be used skillfully in clinical diagnosis. Analysis of the causes has also become more thorough and targeted.
"Maybe taking her blood pressure will reveal something new."
After some diagnosis, Li Jingsheng thought it was necessary to measure the venous pressure of the child's bilateral arms.
Cubital venous pressure is of interest in the diagnosis of this condition.
"It's easy. I'll just go get a blood pressure monitor."
Even Tao refused to take the patient and his family to the inpatient department of gastroenterology.
Can understand his thinking.
If the patient refuses to leave, it will be very troublesome.
Older doctors often do a good job in self-protection.
The blood pressure monitor was brought over, and Li Jingsheng measured the little girl's blood pressure right in the square. Their strange behavior has already attracted some people to watch.
Li Jingsheng didn't care about this.
“Oh my God, this child’s cubital venous pressure is as high as 33cmh2o.
After measuring the child's cubital venous pressure, he was immediately frightened.
This is well above normal.
"Brother Lian Tao, I think the initial diagnosis results of this child's illness have already been obtained."
"You're telling the truth!"
Lian Tao watched from the side. Cardiovascular diagnosis was not his strong point.
He also admired Li Jingsheng even more.
Who would have thought that a very easily overlooked jugular vein bulge actually allowed Li Jingsheng to successfully solve this difficult case.
"The child's jugular veins are distended and the cubital venous pressure is much higher than normal. In addition, the chest CT shows that the pericardium is thickened and has calcification. The cause of the child's abdominal effusion has not been found. I suspect constrictive pericarditis. Just like you As initially speculated, the cause is not in the abdominal cavity or digestive tract, but in the chest cavity."
Li Jingsheng's last words were a compliment to Lian Tao.
After all, he is a chief physician, and now that the cause of the disease has been basically diagnosed, Li Jingsheng cannot be the only one to wear the high hat.
"It's easy to handle once we have a suspicion. I'll contact the cardiovascular medicine doctor immediately. No, she should be a surgeon, right?"
Lian Tao asked Li Jingsheng.
This is a code word.
Surgery means surgical treatment.
"Yes, it would be better to be hospitalized in the cardiothoracic surgery department."
Li Jingsheng nodded to confirm.
"I think there's no need to call, just take her there directly!"
When Lian Tao said this, his expression was somewhat unnatural.
Li Jingsheng has also spent several years in a large hospital, so he naturally knows the ropes.
It is nothing more than a chain of contempt. Internal medicine looks down on surgery, thinking that surgery can only play with knives. Surgery looks down upon internal medicine, thinking that internal medicine can't handle any serious surgery.
The two immediately took the patient and his family to the inpatient department of cardiac surgery.
As for the outpatient clinic, it's already off work.
If you don’t have any acquaintances, the most effective way is to see a doctor at night and go directly to the emergency room.
Anyway, the emergency room is like a transfer station.
The patient is brought in, and after a preliminary diagnosis, the department of gastroenterology calls the department of gastroenterology and asks them to come and recruit the patient. Which surgical department it is, let the corresponding surgical department come over to recruit people.
Some hospitals have great emergency departments, with very detailed divisions into medical and surgical departments, and even have their own inpatient beds.
Some minor operations, such as appendicitis or superficial tumor removal, can all be done in the emergency department.
Not all patients are referred to specialists.
The four of them came all the way to the cardiac surgery department.
As soon as he came in, Li Jingsheng felt the smell of money.
Myocardial infarction, mitral regurgitation, aortic dissection... almost no patient has cheap treatment.
If you replace it with an artificial heart, the little thallium alone will cost one million.
If you don’t have money, you really can’t afford treatment at cardiac surgery.
The medical staff on duty here are very busy. And they are generally aloof.
Lian Tao had some status at People's Hospital, but when he got here, he felt like a passerby.
No wonder he refused to call a doctor he knew.
I'm afraid there is no cardiac doctor who he can talk to and who has some status.
It is quite difficult to establish connections across departments.
"Even the director hasn't gotten off work so late!"
Finally, a nurse who knew him took the initiative to say hello.
But there was no hint of fawning in his tone.
Even with a hint of pride and arrogance.
Xinwai and Shenwai are two notoriously arrogant departments.
Doctors from other departments generally feel a little offended when they come. But there is no other way. They claim to be highly sophisticated in surgery, and they are really proud of it.
Moreover, these two departments have strong revenue-generating capabilities, and the training cycle for doctors is extremely long.
Hospital leaders usually regard the medical staff in these two departments as their 'ancestors'.
As long as it's not too out of the ordinary, I'll dote on you as much as you can.
"This child has abdominal effusion. After preliminary diagnosis, it is likely to be constrictive pericarditis. Do you think there is a way to find a cardiologist to check it out?"
When Lian Tao talks here, why does he feel like he is speaking in a low voice?
Li Jingsheng stood aside and said nothing, just watching quietly.
Director Lian Tao was wronged today because he helped this little girl to be hospitalized.
I just hope that the patient can be hospitalized smoothly.
"Who diagnosed her with constrictive pericarditis?"
An older nurse came over.
Since it was night, there were only three nurses at the nurse station.
Lian Tao was embarrassed for a while.
It must be said that he made the diagnosis. He is a gastroenterologist, so he is a ghost if others don't laugh at him.
It would be even more inappropriate to say that Li Jingsheng made the diagnosis.
Doesn't this mean pushing Li Jingsheng out as a shield to make these people laugh at him?
"I made the diagnosis. Of course, it's just a suspicion, not that it's definitely the disease."
Li Jingsheng glanced at the female nurse lightly.
Today, Li Jingsheng not only earns over 10,000 yuan a day, but also has a certain status in the Second Hospital, so even when he arrives at the People's Hospital, he is not afraid at all.
He just looked at the nurse with a very calm and indifferent look.
"Are you also a doctor at our People's Hospital?"
The nurse looked at Li Jingsheng carefully.
There are four to five thousand employees in the People's Hospital. It is normal for everyone not to know each other.
Clinicians and nurses in the hospital actually only account for a part, while handymen and administrative staff account for the majority.
Some people say that a clinician needs to support three administrative and auxiliary staff. This may be a bit exaggerated, but it should be a common phenomenon in major hospitals. And the smaller the hospital, the more clerks and administrative posts there are.
The amount of nepotism is staggering.
"I'm not."
Li Jingsheng shook his head.
"Then which hospital are you from?"
The female nurse's eyes immediately changed when she looked at him, and her painted brows also raised slightly.
"I just open a clinic." Li Jingsheng thought for a moment, but still did not reveal his identity as a doctor at the Second Hospital. If the diagnosis of this case is wrong, it will only be a trivial matter for him to be personally embarrassed and the reputation of the second hospital will be damaged, which is not worth it.
This sense of collective honor must be present.
"Oh, it turns out he runs a clinic! Is he a barefoot doctor?"
The female nurse is really unforgiving.
Lian Tao couldn't see it and was about to get angry, but Li Jingsheng held him down.
"Actually, it doesn't matter what my identity is. This child's condition is quite serious, and they came from a rural area far away. The key is that you think of a way to get the child timely treatment."
There's nothing to argue with a nurse.
Not even coming here to quarrel.
"What's the matter?"
A male doctor in his thirties came over.
"Hey, Li Jingsheng, is it really you?"
The male doctor was slightly surprised when he saw Li Jingsheng.
"Zhang Chao, I didn't expect you to come to the People's Hospital after taking the Ph.D. exam. Congratulations!" Li Jingsheng couldn't help but sigh when he saw the student with the most outstanding grades in the class.
Everyone's destiny is different.
Talented students, lucky students, or students with related backgrounds all took off after graduation or continued their studies.
An ordinary medical student like him has no way to compare with these people.
At first, Li Jingsheng stopped studying after finishing his master's degree.
The family's financial situation does not allow it.
Another one is that my academic talent is not top-notch. Find a job early, make money and marry a wife, strive to become a chief physician, and then live a good life. It can also repay his parents who worked hard to support his education.
That was the original idea.
Zhang Chao is the top academic in the class, he is really awesome.
The kind of talented person.
Nowadays, after people finish their PhD studies, they go directly to the People's Hospital, and they enter the very awesome cardiac surgery department.
The future is bright.
It's really enviable.
Of course, Li Jingsheng would have envied Zhang Chao before, but now, he really despises such a job as a cardiac surgeon.
"I heard that you worked at the No. 1 Hospital for a few years but were unsatisfied, and then you resigned and opened a clinic. Are you okay now? Old classmate."
Zhang Chao was quite enthusiastic when he saw his old classmates.
There is a slight hint of condescending arrogance, but it is not particularly obvious.
He must have despised Li Jingsheng in his heart, there was no need to even think about it.
Li Jingsheng couldn't survive in the First Hospital, so he had to open his own clinic. But he already has a doctorate and has entered a top-tier university like the People's Hospital. In comparison, he is naturally proud of himself.
"Oh, that's it! This little girl has been seeking treatment for a day and has not been admitted. Can you please help and see if she can be admitted to the hospital?"
Li Jingsheng behaved extremely low-key.
Lian Tao saw all this, but said nothing.
Lian Tao knew Li Jingsheng's current situation. Not to mention that he was doing very well, at least he was much better than Zhang Chao.
Even though Zhang Chao is a doctoral student, this kind of academic qualifications are nothing at all in the People's Hospital.
Li Jingsheng not only runs his own clinic and earns a lot of income, but also runs the orthopedic surgery clinic of the Second Hospital. His status and income are not comparable to Zhang Chao.
To be realistic, the Second Hospital relies heavily on Li Jingsheng because there are too few bone-setting talents.
No one can replace it.
On the contrary, although Zhang Chao has dazzling academic qualifications, to the People's Hospital, he is just an ordinary young doctor.
Maybe after more than ten years of training, when Zhang Chao develops some skills, the People's Hospital will take him seriously.
At least not now.
"I heard you guys talking about constrictive pericarditis just now. Did you diagnose it?"
Zhang Chao had already started to check on the little girl.
At least I can give my old classmates some face.
"Yes, I diagnosed it."
Li Jingsheng admitted directly.
Zhang Chao nodded, "I'll show it to her first."
Next, Zhang Chao began to understand the little girl's symptoms and condition, and looked at the examination data.
"This case is not easy to diagnose, and I am not sure. Okay, after Director Shang completes the operation, I will ask him to help take a look. If it is really an extracardiac disease, I will find a way to help her get hospitalized. Old Classmate, I still have to send things back to the operating room, so I have to leave first. Just let them sit there and wait. Keep in touch when you have time!"
This last sentence is just a polite statement.
Contact me.
Apart from their class WeChat group, Li Jingsheng didn't even know Zhang Chao's phone number.
How to contact?
Watching Zhang Chao leave in a hurry, Li Jingsheng looked at the woman.
"Sister, just sit here and wait. If you can't be hospitalized, you can call me."
Now that Li Jingsheng has found out the cause of the disease.
If the People's Hospital doesn't accept the call, he can ask the director of the cardiac surgery department of the Second Hospital for mercy, and he might be able to take him in.
After all, this is also an opportunity to earn cmI index.
"Brother Lian Tao, let's withdraw first! Your time was wasted today. Thank you for your help."
Li Jingsheng held Lian Tao's hand tightly.
"What's the point? It's just a matter of a few steps. I really can't say anything outside of my heart, and it doesn't really help much."
The two of them walked towards the elevator while talking.
"Would you like to sit in my office and drink tea?"
"It's too late today, let's wait another day! My clinic is about to expire recently, and I have to change the location, but I haven't settled on it yet. There are a lot of things." Li Jingsheng said these things because he regarded him as a good friend.
"It's good to change to a different place! If you want to change, just change to a bigger place. Only in this way can we have a chance to become bigger and stronger."
Lian Tao has never opened a clinic before, so he really doesn't feel pain in his back while standing and talking.
How can it be so easy to change to a bigger place?
It's hard to find a place, and the rent is unaffordable.
Don't look at the fact that his clinic now has a daily income of over 10,000 yuan. That's because the health medicines are sold well.
The income from diagnosis and treatment is still far from breaking 10,000 yuan.
Don't even think about it if you don't wait for three to five years.
"By the way, if you can get involved in the elimination of old equipment in the operating room at the People's Hospital, please contact me. I need to buy a high-quality X-ray detection equipment, as well as shadowless lamps, electrocoagulation scalpels and other equipment .”
If Li Jingsheng can really move to that small courtyard, then the conditions for carrying out surgery business will be better.
It is entirely possible to build an operating room.
When it comes to buying equipment, because he doesn't have enough funds, he still prefers to buy old equipment that has been retired by large hospitals.
On the one hand, the quality is guaranteed, and on the other hand, the price is affordable.
Many large hospitals upgrade quickly, and the equipment that has been eliminated contains good things.
