Gou is practicing medicine in the clinic

Chapter 195 Successful Diagnosis, The Scenery of an Old Classmate
The life of the poor is cheap, this is a very cruel reality.

The woman was reluctant to spend money, but felt sorry for the child, so she only bought a piece of bread for the child to eat.Even if the child ate leftovers, she would rather be hungry than eat them.

"Later, if the child is successfully admitted to the hospital, you still need to eat something. The child still needs you to accompany him. If he doesn't eat and falls ill, there will be no one to take care of the child."

Li Jingsheng said to her.

"Come on, let me see how the child is doing."

He first checked the child's breathing, which was obviously heavy and short.

Not to mention the complexion, it is completely sick.

"Is the child's breathing so heavy all the time?"

Li Jingsheng asked.

"I asked, and she said that there has always been heavy breathing, but it is more serious now."

Lian Tao answered on behalf of the woman.

Under normal circumstances, a child should not be breathing so heavily.

Such heavy breathing is possible only after strenuous exercise.

First, observe the child's nostrils to see if there are nasal polyps and 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 light.

No abnormalities were found in the nostrils.

"Hey, why are the blood vessels on this neck so thick?"

After Li Jingsheng saw his nose, he naturally checked his neck.

As a result, at a glance, the child's neck blood vessels bulge very high.Like an angry man, with a red chest, a thick neck, and bulging veins.

At first, I thought that the child's neck was leaning on his mother's shoulder, so the blood vessels on the neck were so obvious.

After straightening the child's head, the blood vessels were still bulging.

This time, Li Jingsheng was sure that the child's neck veins must be abnormal.

"Brother Lian Tao, her jugular veins are swollen. I have never seen such a situation. Have you seen it?"

"I have seen that many of these conditions are caused by narrowing of blood vessels."

Lian Tao is well-informed, and after taking a closer look, he has already begun to think new things.

Li Jingsheng's cardiovascular diagnosis and thoracic diagnosis have reached the proficient level, but when diagnosing such a case that has never been encountered, it seems a bit insufficient.

He has accumulated a lot of life points for a while, which was originally planned to be used for leveling up experience.

It's been a while since I've been stuck as a junior attending physician.

At present, his grade experience has risen to 1674.5/2000, a junior attending physician.

Because there were a few surgeries in the operating room, plus he was alone in the manipulative reduction outpatient clinic, and the number of patients in the Sunshine Clinic was also considerable, his level of experience was unknowingly only 300 points away from being promoted to It's next level.

His current health balance is 711 points.

Not to mention rich and powerful, at least it is still considerable.

I feel that the little girl's distended jugular veins should be related to the lungs or pericardium.

At this moment, should we upgrade the diagnostic skills of thoracic surgery, or the diagnostic skills of cardiovascular medicine?This is a difficult problem.

Thoracic surgery basically does not involve the pericardium.

Li Jingsheng gritted his teeth and finally chose to upgrade the diagnosis of cardiovascular medicine.

Spending 387 points of life, successfully raised its proficiency to Xiaocheng.

Cardiovascular internal medicine diagnosis minor score 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.

If you collect two more points, you can upgrade the doctor level by one level.

It's not difficult at all.

As long as the child's cause is diagnosed, at least 1 point of life can be obtained.

In fact, in difficult cases like this, the life value rewards have never been stingy.

At least 10 points.

Li Jingsheng tried to get the child's film, and then combined with the child's actual situation to make a diagnosis.

If the jugular vein is really stenotic, it must be narrow at the top and wide at the bottom if you want to create such a distended effect.

With a small-level cardiovascular medical diagnosis, many problems can be easily solved.

The various etiologies of cardiovascular disease are becoming more familiar.

At the time of diagnosis, like a seasoned old attending, become well-informed.

The related disease cases I have seen in normal times, and the medical knowledge in this area are all integrated and can be skillfully used in clinical diagnosis.The analysis of the etiology has also become more thorough and more targeted.

"Perhaps taking her blood pressure will reveal something new."

After some diagnosis, Li Jingsheng thought it necessary to measure the child's bilateral arm venous pressure.

Cubital venous pressure is useful for the diagnosis of this condition.

"It's simple, I'll just go and get a blood pressure monitor."

Lian Tao refused to bring the patient and his family to the inpatient department of the Department of Gastroenterology.

Can understand his thoughts.

If the patient refuses to leave at that time, it will be very troublesome.

Older doctors tend to do a good job of self-protection.

The sphygmomanometer was brought over, and Li Jingsheng measured the little girl's blood pressure in the square.Their strange behavior has already attracted some people to watch.

Li Jingsheng didn't care about this.

"Oh my god, this kid's cubital vein pressure is as high as 33cmH2O.

After measuring the cubital vein pressure for the child, he was directly frightened.

This is far beyond normal.

"Brother Lian Tao, I think the child's cause has already been confirmed by the first diagnosis."

"You said it!"

Lian Tao watched from the side. Cardiovascular diagnosis was not his forte.

He admired Li Jingsheng even more.

Who would have thought that a jugular vein bulge that is easily overlooked would allow Li Jingsheng to solve this difficult case smoothly.

"The child's jugular veins are distended, and the pressure of the cubital vein is much higher than the normal level. In addition, the chest CT shows that the pericardium is thickened and calcified. The cause of the child's peritoneal effusion has not been found. I suspect that it is constrictive pericarditis. Just like you As originally speculated, the cause is not in the abdominal cavity, not in the digestive tract, but in the chest."

Li Jingsheng's last sentence was a compliment to Lian Tao.

At any rate, he is a chief physician, and now that the cause of the disease has been basically diagnosed, Li Jingsheng can't just let Li Jingsheng wear the high hat.

"If you have doubts, it's easy to handle. I will immediately contact the doctor of cardiovascular medicine. No, she should be a surgeon, right?"

Lian Tao asked Li Jingsheng.

This is a code word.

Surgery means surgery.

"Yes, it would be better to go to the cardiothoracic surgery department."

Li Jingsheng nodded in confirmation.

"I think there's no need to make a phone call, just take her there!"

When Lian Tao said this, his expression was somewhat unnatural.

Li Jingsheng also worked in a big hospital for a few years, so he naturally knows the way.

It is nothing more than a chain of contempt. Internal medicine looks down on surgery, thinking that surgery can only play with knives.The surgeon looked down on the internal medicine department, thinking that the internal medicine department would not be able to deal with even bigger operations.

The two immediately took the patient and their family members to the inpatient department of the Cardiac Surgery Department.

As for the outpatient clinic, they have already left work.

If there are no acquaintances, it is the most effective way to see a doctor at night and go directly to the emergency room.

Anyway, the emergency department is equivalent to a transfer station.

Take the patient in, and after a preliminary diagnosis, if it is Gastroenterology, call the Gastroenterology Department and ask them to come over to find someone.Whichever surgical room it is, let the corresponding surgical room come over to find people.

The emergency department of some hospitals is relatively good, and the division of internal medicine and surgery is very detailed, and they even have their own inpatient beds.

Some minor operations, such as appendicitis, cutting a superficial tumor, can all be done in the emergency department.

It's not that all patients are pushed to specialists.

The four came to the heart surgery together.

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 it is replaced with an artificial heart, the small thallium alone will cost millions.

Without money, it really can't be cured in cardiac surgery.

The medical staff on duty here are busy.And generally colder.

Lian Tao has some status in the People's Hospital, but when he gets here, he feels like a passerby.

No wonder he refused to call the doctor he knew.

I'm afraid there is no heart surgeon who can talk to him and has some status.

It is quite difficult to establish contacts across departments.

"Director Lian hasn't got off work so late!"

Finally a nurse who knew him took the initiative to say hello.

However, there was no flattering taste in his tone.

Even with a hint of pride and arrogance.

Xinwai and Shenwai are two well-known tsundere departments.

When doctors from other departments come over, they generally feel a little angry.But there is no way, people claim to be high-tech in surgery, and they really have this proud capital.

Moreover, the income-generating capabilities of these two departments are very strong, and the doctor training cycle is extremely long.

Hospital leaders usually treat the medical staff of these two departments as 'ancestors'.

As long as they are not too outrageous, they can be pampered as much as they can.

"This child has peritoneal effusion. After preliminary diagnosis, it is likely to be constrictive pericarditis. Do you think there is a way to find a cardiologist?"

When Lian Tao spoke here, why did he feel humbled?
Li Jingsheng stood by and didn't speak, just watched quietly.

Director Lian Tao was wronged today in order to help this little girl in the hospital.

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 should be said that he diagnosed it. He is a gastroenterologist, so it would be a ghost if he didn'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?
"I diagnosed it. Of course, it's just a suspicion, not necessarily the disease."

Li Jingsheng glanced at the female nurse indifferently.

Today's Li Jingsheng not only earns more than [-] yuan a day, but also has a certain status in the Second Hospital, so even if he goes to the People's Hospital, he is not shy at all.

Just looking at the nurse with a very calm and indifferent look.

"Are you also a doctor at our People's Hospital?"

The nurse stared at Li Jingsheng carefully.

There are 5000 employees in the People's Hospital, and it is normal for everyone not to know each other.

In fact, clinicians and nurses in the hospital only account for a part, and office staff and administrative staff account for the majority.

Some people say that a clinician needs to support three administrative and miscellaneous staff. This may be a bit exaggerated, but it should be a common phenomenon in major hospitals.And the smaller the hospital, the more miscellaneous staff and administrative posts.

There are so many nepotisms of all kinds that people are speechless.

"I'm not."

Li Jingsheng shook his head.

"Then which hospital are you from?"

The way the female nurse looked at him changed immediately, and her drawn brows also slightly raised.

"I am the only one who runs a clinic." Li Jingsheng thought for a while, but still did not report the identity of the doctor of the Second Hospital.If the diagnosis of this case is wrong, it will only be a trivial matter to embarrass him personally, and the reputation of the Second Hospital will be damaged, which is not worth it.

This collective honor consciousness must have.

"Oh, so it's a clinician! A barefoot doctor?"

The female nurse's mouth is really unforgiving.

Lian Tao couldn't see it from the side, and was about to get angry, but Li Jingsheng held it down.

"Actually, it doesn't matter what my identity is. The child's condition is quite serious, and they came from a faraway village. You should think of a way to get the child timely treatment."

There's nothing to argue with a nurse.

It's not like they came here to fight.

"what's wrong?"

A male doctor in his 30s came over.

"Hey, Li Jingsheng, is it really you?"

The male doctor was a little 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 feel very emotional when he saw this student with the most dazzling grades in the class.

Everyone's fate is different.

Talented students, or students with good luck, or students with background connections, take off after graduation or continue their studies one by one.

An ordinary medical student like him has no way to compare with these people.

At the beginning, Li Jingsheng did not study again after finishing his master's degree.

Family economic situation does not allow.

Another one is that my own academic talent is not considered top-notch. Find a job early, earn money to marry a wife, and strive to become a chief physician and live a good life.It can also repay the parents who worked hard for him to study.

That's the original idea.

Zhang Chao is the top student in the class, he is really amazing.

It's the kind of talent.

Now after finishing their Ph.D., they go directly to the People's Hospital, and they go to a very good cardiac surgery department.

The future looks bright.

It's really enviable.

Of course, Li Jingsheng used to envy Zhang Chao, but now, he really despises such a job as a heart surgeon.

"I heard that you worked in the No. [-] Hospital for a few years, but you were unhappy, and then you resigned to open a clinic. How are you doing now? Old classmate."

Zhang Chao was quite enthusiastic when he saw his old classmates.

Wei Wei has a hint of condescending arrogance, which is not particularly obvious.

In my heart, I must despise Li Jingsheng, so I don't even need to think about it.

Li Jingsheng couldn't get along in the No. [-] Hospital, so he had to run his own clinic.But he already has a doctorate, and even entered the top three of the People's Hospital.In comparison, it is naturally a spring breeze.

"Oh, that's it! This little girl has been seeking treatment for a day and has not been admitted. Can you help me see if she can be admitted to the hospital?"

Li Jingsheng behaved extremely low-key.

All of this was seen by Lian Tao, but he didn't say anything.

Lian Tao knew Li Jingsheng's current situation, not to mention that he was doing very well, at least he was much better than this Zhang Chao.

Don't look at Zhang Chao as a doctoral student, but this kind of education is nothing at all in the People's Hospital.

Li Jingsheng not only runs a clinic by himself, and earns a lot of money, but also stands alone in the bone setting clinic of the Second Hospital. His status and income are not comparable to Zhang Chao's.

To be more realistic, the Second Hospital relies heavily on Li Jingsheng, because there are too few bone-setting talents.

No one can replace it at all.

On the contrary, although Zhang Chao has a dazzling academic record, 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 pay attention to him.

At least not now.

"I heard you talking about constrictive pericarditis just now. Did you diagnose it?"

Zhang Chao has already started to check on the little girl's situation.

Anyway, give the old classmates a little face.

"Yes, I diagnosed it."

Li Jingsheng directly admitted.

Zhang Chao nodded, "I'll show her first."

Next, Zhang Chao began to understand the little girl's symptoms and condition, and checked the examination materials.

"This case is not easy to diagnose, and I'm not sure. That's all right. After the operation, Director Shang will ask him to take a look. If it is really a disease outside the heart, I will find a way to help her get hospitalized. Mr. Classmate, I have to send things back to the operating room, so I’m leaving first, you just let them sit there and wait. Keep in touch when you have time!”

The last sentence is just a polite sentence.

Contact shit.

Apart from the class WeChat group between the two, 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, then you can sit here and wait. If you can't be hospitalized, you can call me again."

Now that Li Jingsheng has found out the cause of the disease.

In case the People's Hospital refused to accept him, he asked the director of the Cardiac Surgery Department of the Second Hospital to intercede, and he might be able to accept him.

After all, this is also an opportunity to earn CMI index.

"Brother Lian Tao, let's withdraw first! I wasted your time today, thank you for your help."

Li Jingsheng held Lian Tao's hand tightly.

"What's the matter, it's just a matter of lifting a finger. I really can't say anything on the outside of my heart, and I can't help much."

The two walked towards the elevator while talking.

"Come to my office and have some tea?"

"It's too late today, let's try another day! My clinic is about to expire recently, and I need to change places, but I haven't settled down yet. There are a lot of things." Li Jingsheng only talked about these things because he regarded him as a good friend.

"It's good to change the place! If you want to change, change to a bigger place, so that you have the opportunity to become bigger and stronger."

Lian Tao has never opened a clinic, so he really doesn't feel backache when he is standing and talking.

How can it be so easy to change to a bigger place?

The place was hard to find, and the rent was unaffordable.

Don't look at his clinic's current daily income of more than [-], it's because the health care medicine is selling well.

If the income of diagnosis and treatment wants to exceed [-] yuan, it is still far away.

Don't even think about it for three to five years.

"By the way, if there is obsolete equipment in the operating room at the People's Hospital, if you can get it online, please contact me. I need to buy a high-quality X-ray detection equipment, as well as shadowless lamps, electrocoagulation knife and other equipment .”

If Li Jingsheng could really move to that small courtyard, the conditions for carrying out surgery business would be better.

It is entirely possible to build an operating room.

To buy equipment, because of insufficient funds, he still tends to buy old equipment that has been eliminated by large hospitals.

On the one hand, the quality is guaranteed, on the other hand, the price is affordable.

Many large hospitals are updated quickly, and there are good things in the equipment that has been eliminated.

(End of this chapter)