Fortunately, the four employees and him, the boss, each performed their own duties, and they were able to complete the work in time.
As long as there are not too many patients, there is generally no need to work extra overtime.
Selling medicines and the like are basically not time consuming.
At this time, Li Jingsheng's cell phone rang several times in succession.
It’s the sound of WeChat messages.
After checking, it turned out that it was sent by Director Lian Tao.
"I checked the patient's abdominal B-ultrasound twice more, one of which was done by me personally, and no pancreatic abnormalities were found in either case."
"CT and enhanced abdominal aorta and pancreas scans only showed multiple low-density lesions of varying sizes and uneven density in the right, left, and caudal lobes of the liver, and no pancreatic space-occupying lesions were found."
It seems that Director Lian Tao still suspects that there is something wrong with the patient’s pancreas!
Li Jingsheng was also so suspicious.
Because the patient continued to lose weight inexplicably, it was either a malignant tumor or diabetes. Problems with the pancreas can cause poor absorption by the body.
Although the pancreas is small in size, only 14 to 15 centimeters long and 3 to 4 centimeters wide, it is a very important digestive organ in the human body.
Can help the body digest fat, protein and glucose.
When it goes wrong, it can not only lead to poor digestion of the human body, but can even lead to death.
It belongs to a very special existence among all digestive organs.
If we regard the digestive organs as martial arts people, we can describe them as both internal and external.
Its exocrine function is mainly to secrete pancreatic amylase, protease and other substances needed for human digestion from pancreatic alveoli and pancreatic ducts, including some important digestive juices.
Endocrine function mainly secretes glucagon that the body needs to control blood sugar, and insulin is used to control the decrease and increase of blood sugar.
It can be seen from here that it plays an extremely important role in controlling the digestive function of the human body and controlling and regulating the blood sugar of the human body.
This patient's stool is fine, indicating that the possibility of intestinal problems is relatively small.
Liver function was also normal.
Urine routine is also normal.
It really makes people suspect that there is something wrong with the pancreas.
However, the patient's fasting blood sugar is normal, and two abdominal ultrasounds have shown that the pancreas is normal.
So what is the problem?
Although no pancreatic space-occupying lesions were found in the patient's abdominal contrast-enhanced CT, low-density lesions were found in the liver, indicating that there must be a problem.
"Why not get an angiogram?"
Li Jingsheng replied to Lian Tao.
"Could it be some beautiful lady who asked you to go to dinner?"
Ou Qinglan felt a little bit annoyed when she saw Li Jingsheng holding the mobile phone with a caring expression, and even left her aside in the cold.
In fact, she is quite good, and she is the kind who doesn't get jealous easily.
Some girls are always unsure of themselves and worry about their boyfriend being snatched away all day long. To answer a phone call, send a message, or come home late, you have to dig deep.
It's really unbearable.
Ou Qinglan almost never interfered in Li Jingsheng's private life.
Of course, it may be that the two of them are still in the early stages of dating, and when they get married, they will probably be more strict.
"A doctor from the People's Hospital encountered a difficult case. The patient's three basic routine tests were all normal, but he was inexplicably thin, weak, and unable to walk. He discussed it with me."
Li Jingsheng explained.
"You're not so awesome, are you? Is it our Lijiang People's Hospital?"
Ou Qinglan didn't care about the condition, but was surprised by the doctor's identity.
"What's wrong with this! What's wrong with the doctors at the People's Hospital? Aren't they just like us, with two eyes and one nose?"
Li Jingsheng was very calm.
That is to say, he is now stronger, has an attribute panel, and continues to improve various medical skills. In the future, there is a high probability that he will become the chief expert in the medical field in Jiangli City, and even become the top person in the country.
At least in his field of expertise, he should be able to rise to the top level.
At present, he has mastered several of the most important medical and surgical diagnostic skills, as well as prescription medicine and surgical skills.
He was not prepared to expand the scope any further.
Being a general practitioner is not easy, and even if he has an attribute panel that can improve his medical skills, it is not easy to develop general medical skills.
The various medical skills he already possesses are very difficult for him.
"Aren't the doctors at the People's Hospital great? We doctors in ordinary tertiary hospitals can only look up to others. Did the other party take the initiative to discuss it with you? Or did you take the initiative to ask for it?"
In Ou Qinglan's mind, the People's Hospital is definitely the top institution.
"Hey, I discovered that our Doctor Ou also has a gossipy side! He took the initiative to discuss it with me. We are friends and he is a male doctor."
"I didn't ask you if the other person was a boy or a girl. Besides, I'm not that stingy."
She said that, and Li Jingsheng took the initiative to reveal the other person's gender, which still made her feel happy and relieved.
I was really afraid that the other party was a young and beautiful female doctor from the People's Hospital. She discussed the condition with Li Jingsheng, and they became a couple after discussing.
Ou Qinglan is very confident in her appearance, but in terms of medical skills, she is still only a master's degree candidate in graduate school.
Medical skills are average.
While the two were talking, Lian Tao messaged back again.
"You also think we should have an angiogram?"
"Sure!"
Li Jingsheng replied.
"Percutaneous femoral artery angiography is an option."
he added.
After sending this message, Li Jingsheng was surprised. When did he become so powerful?
After thinking about it for a moment, he felt relieved again.
It is probably because he has a certain level of cardiovascular medical diagnosis and extracardiac diagnosis, so he can use clinical medical knowledge in various fields when facing this kind of digestive tract disease.
"I found that Jingsheng's clinical knowledge is more profound than I thought. I really don't know if you are so good, why don't you go to a big hospital?"
Lian Tao felt that Li Jingsheng's strength and level were very high, even if he was placed in a top-three hospital like the People's Hospital, he would still be outstanding.
"Don't make fun of me. My little knowledge is not worth a finger of yours. My girlfriend is here and I won't talk to you anymore."
Li Jingsheng didn't dare to show off in front of Lian Tao.
"You value sex over friends! I despise you! I will tell you later when the results come out."
Lian Tao seemed satisfied with the discussion.
I am afraid that when encountering difficult cases in the future, I will think of Li Jingsheng immediately.
After Tang Ping and others finished their work, Li Jingsheng checked the accounts and found that there were no problems. Then I checked the medical records of that day and found that there was no problem either.
He locked the door with confidence and went to dinner with Ou Qinglan.
This time, he did not choose to eat egg fried rice, but took her into the restaurant.
She seems to have really changed.
When ordering, I only ordered two cheap vegetarian dishes, one with oil-soaked tofu and one with cabbage.
"At least order some meat!"
Li Jingsheng said to her.
"I need to lose weight, otherwise what if I gain weight and be rejected by you?"
“Then order some shrimp!”
Li Jingsheng ordered fried leeks with shrimps.
She was very delicate when eating, but shrimps were her favorite.
Li Jingsheng saw that she loved to eat, so he basically didn't use his chopsticks.
At this time, her cell phone rang.
He glanced at it, then picked up the phone and walked to a farther place to answer it.
This kind of thing has never happened.
Li Jingsheng felt that there must be something wrong with her avoiding him.
Judging from her performance, the possibility of riding two boats is very slim.
She seems to have become a lot more frugal recently. Could it be that her finances are in trouble?
It shouldn’t be possible either!
The bag she carries and the watch she wears are all famous brands, and her family background should not be bad.
And not long ago, when Li Jingsheng was worried about the storefront, she went back to her hometown, probably to ask her parents for money and prepare to buy a storefront for him to use.
Li Jingsheng faintly heard her say, Got it... I'll give it to you in two days.
What is going on?
This little girl makes people worry!
In two days, wouldn't it be the day when the second hospital pays wages?
He was excited. It seemed that Ou Qinglan's finances might really be in trouble.
After the two of them finished eating, if it had been before, she would have rushed to pay the bill.
This time, Li Jingsheng paid the bill.
"Qinglan, it seems your birthday is coming soon, right?"
Li Jingsheng held her hand and walked along the old street in the south of the city.
"You know this!"
She responded with a smile.
"That's necessary! I'm very busy at work every day, you know this! I don't have a good memory. When I'm busy, I only have patients in my mind. If you forget your birthday, it will be a big sin. Big.”
Li Jingsheng said to her.
"Look what you said, what does this have to do with anything! Besides, I'm planning to treat you to dinner when it's my birthday! I can take the initiative to call you then!"
She said indifferently.
"No, no, no, it's your intention that you treat me to dinner, and it's my intention that I give you birthday gifts and blessings. I'll give you three thousand yuan, and you can buy whatever you like. If it's less, don't make up for it, and if it's too much, it's okay. No need to retreat, do you think it’s okay?”
If Li Jingsheng gave him money directly, she would definitely not accept it.
It also hurts her self-esteem.
Just thought of this method.
Because he wanted to save money to buy this small yard, he didn't give much.
There are three thousand yuan, and with a little saving, it will be enough for her to spend a month.
If you want to buy expensive clothes and cosmetics, it will definitely not be enough.
Li Jingsheng can only guarantee her food and clothing now, but cannot satisfy all her material desires.
"I don't want your money. And you don't need to give me any expensive gifts for my birthday. I will be very happy even if you write a love letter. Haha, speaking of this, we have been in love for a while, and you have never written me a love letter. Woolen cloth!"
She is easily satisfied.
"You have to listen to me on this matter, unless you treat me as an outsider."
Li Jingsheng took out his mobile phone and transferred three thousand to her.
She opened the screen and was about to retreat immediately, but Li Jingsheng stopped her.
"Take it! Whether we go shopping or eat in the hospital, you are basically paying the bill. This little money is a little thought from me. You can buy whatever you want for your birthday."
Li Jingsheng looked into her eyes sincerely.
"No, I don't want your money. My mother has taught me since I was a child that girls must respect themselves and love themselves, and not accept money or expensive gifts from men. If you respect me, don't force me to accept this money."
She firmly disagreed.
The two of them had already walked to the clinic, opened the door, and Li Jingsheng pulled her in.
"Qinglan, am I your boyfriend?"
"What do you think?"
She rolled her eyes.
If you don't admit that he is your boyfriend, is it possible to give him a hug and hold hands?
Is it possible to send him messages and chat every day?
Maybe because of him, he ran home to his parents to ask for money to buy a storefront?
"I love you very much, and it is only natural to take care of you. It is also natural for a man to make money to spend on his wife and children. Although we are not married yet, as long as you are willing, I can get the certificate with you at any time. But you have to go through your parents. If so, you have to give me some time, my career has just started, you know this."
Li Jingsheng hugged her and faced each other.
"That can only be discussed after we get married. We are not husband and wife yet."
She refused again.
"Did you... encounter any difficulties?" Li Jingsheng swallowed these words back in his stomach and did not ask in the end.
Because he was worried about hurting her self-esteem.
"Well, if you need money, you can ask me for it at any time. If you really don't want to accept my gift, just write an IOU. The more you can borrow, the better. If you can't pay it back, I'll give you Pawn becomes my wife.”
Li Jingsheng said in a joking tone.
Phew!
"You are the only one with many bad ideas!" She covered her mouth and snickered.
The time the two of them spend together seems to always be so happy, and Li Jingsheng can make her laugh happily every time.
…
Near eight o'clock, Director Lian Tao sent another message to Li Jingsheng.
"An angiogram showed multiple space-occupying lesions in the patient's liver, a mass in the body and tail of the pancreas, and calcifications in the middle. It seems that my hunch and initial diagnosis were correct. There is really a problem with the patient's pancreas. I just didn't expect it to be in the tail. B-ultrasound cannot detect it at all.”
Lian Tao successfully detected the lesion and seemed very excited.
The diagnosis of this case was indeed very difficult. Fasting blood sugar, B-ultrasound of the liver, kidneys, and pancreas, as well as blood, stool, and urine were all normal.
Who could possibly have some lesions inside the liver?
Then a mass appeared in the tail of the pancreas.
"This patient's tumor may have metastasized!"
Li Jingsheng replied.
"You are really awesome. You are right again. There are space-occupying lesions in the body and tail of the pancreas, multiple space-occupying lesions in the liver, and the bone scan shows multiple bone metastases. At present, it is initially suspected to be glucagonoma in the body and tail of the pancreas, a very rare disease. A rare tumor. Our gastroenterology department can no longer handle this disease, so we arranged to transfer it to surgery overnight."
After checking here, the cause of the disease is revealed to the world.
It’s just that the results of the treatment are quite worrying.
Multiple metastases have occurred, and the effectiveness of surgical treatment is still a question mark.
This patient must be in an advanced stage.
"Jingsheng, do you know why pancreatic tumors were not detected by CT or B-ultrasound?"
"Please enlighten me. If I were to guess, the density of the tumor should be about the same as that of the pancreas."
The only result Li Jingsheng could think of was this.
This kind of thing is rarely encountered, but he also encountered one when he was in the Department of Internal Medicine.
It's just that the patient's tumor was in the liver.
At that time, the patient had a cough. After the superior doctor took a radiograph of the patient, he treated it as a pulmonary infection.
As a result, no treatment was effective.
And on the third day, the patient began to cough up blood.
Later, the patient died, and his family members believed that the First Hospital did not provide adequate treatment and requested an autopsy.
An autopsy revealed a tumor in the patient's liver that had metastasized to the lungs.
The patient's death was not due to terminal cancer, but due to respiratory failure combined with asthma.
In that lawsuit, the First Hospital lost, and I heard it paid more than 800,000 yuan.
Li Jingsheng only knew that for more than two months after that, the deputy chief physician's face was gloomy. He gets angry at the smallest thing. Later, Li Jingsheng resigned, so he no longer had to look at the deputy chief physician's face.
The First Hospital should have borne part of the compensation, but the deputy chief physician must have also paid a lot.
Otherwise, if you pay tens of thousands of yuan or several thousand yuan, your face will not be gloomy for more than two months.
It can be seen from this that doctors are a high-risk profession. After more than ten years of hard work, the income may be lost if something happens to a patient.
Lian Tao directly sent a thumbs up expression.
"You guessed it right again. Director Jin of the Oncology Department said that this pancreatic endocrine tumor cannot be detected with CT or B-ultrasound because it has the same density as the pancreas. If you encounter similar cases in the future, be sure to save more Mind’s eye.”
Through the discussion and exchange of this case, Li Jingsheng learned a lot.
Doctors spend their lives learning because there are so many types of diseases.
All kinds of weird diseases, imaginable.
Ou Qinglan accompanies him in the clinic. He really hopes to marry her soon. The two are tired of being together like this every day.
It feels so empty to live alone in a clinic at Nottingham University.
Sometimes I feel empty inside.
If he could marry her, they could live together in the clinic and have two or three children, and a new family would be perfect.
"By the way, Qinglan, let me teach you how to practice sewing and knotting!"
"Okay! I finally got a chance to suture the skin from Professor Wu during today's surgery. But the suturing was poor and I was severely criticized in public."
She was a little depressed when she talked about it.
Basically every novice doctor comes here like this.
"Then you have to practice hard. When you are done practicing, you will give them a big surprise."
Li Jingsheng's worst stitching skills are at the master level.
Professor Wu's group is definitely top-notch.
I can only say that I really cannot praise the suturing skills of Professor Wu and others.
Taking out the tweezers, suture needle, needle holder, and suture thread, Li Jingsheng began to teach her how to sew step by step.
It's different having a great boyfriend. He taught her how to do intermittent suturing, and after only practicing for less than two hours, her level improved significantly.
(End of chapter)
