Gou is practicing medicine in the clinic

Chapter 246 Can't just be used to it, the result came out
After Li Jingsheng took a taxi to Qiaobang Hospital, he sent a message to the 'Chief Internal Medicine'.

"I have arrived at Qiaobang Emergency Department. Where is the patient?"

It's hard to imagine that the whole building is an emergency center.

The strength of Qiaobang Hospital is not only reflected in the difficult and critical cases successfully diagnosed and treated every year, but also in the scale of the hospital.

Even the People's Hospital didn't dare to be so domineering.

For such a top-level hospital, it is not difficult to acquire land to build a building in Lijiang City, where land is very expensive.

After all, its annual revenue is said to exceed 200 billion.

Li Jingsheng's Sunshine Clinic is nothing compared to Qiaobang Hospital.But he has his advantages, and there is no need to compare his size with others.

"Come and pick you up right now!"

The head of internal medicine responded quickly.

After a while, an elderly man with a Mediterranean haircut came out in a hurry, followed by a man in his 30s with fierce eyes.

"Is it the Chief of Internal Medicine?"

Li Jingsheng tried to ask the elderly man.

Logically speaking, Boss Zhao should come with him.

After all, he was the one who asked Li Jingsheng for help.

Should accompany.

But Boss Zhao has always been a cunning and cunning person. He can ask someone to help with such a bad thing, but he won't go up to it.

It must have been hiding on purpose.

It is right to think about it, he is different from Li Jingsheng.The head of internal medicine is Boss Zhao's benefactor and has a close relationship.

If Boss Zhao comes with him, in case something happens, will he care or not?
If he doesn't care, the relationship between the Chief Internal Medicine Manager and him will definitely become unfamiliar in the future.If you take care of it, you will get into trouble.

Li Jingsheng was different, he came to help out of affection, if he couldn't help, he could just turn around and leave.

"It's me, it's me! Thank you very much for coming here to help with the consultation at such a late hour!"

The older man looked to be around 60 years old.

Maybe I have been threatened and abused by my family members these days, and I am exhausted physically and mentally.Under such tremendous ideological pressure, one can imagine the mental state of the whole person.

Being able to persevere and not fall is considered very strong.

It's just that the haggard look on his face cannot be concealed, and the wrinkles at the corners of his eyes, forehead, etc. are even more obvious.Very large eye bags and severe dark circles.

The smile is terrifying, like a zombie in a zombie movie forcing a smile.

"Oh, by the way, let me introduce myself, my name is Shao Bing. This is the father of that little girl."

The elderly man quickly introduced himself.

Worried that Li Jingsheng didn't know his depth, he also introduced the identity of the young man with fierce eyes.

In fact, his worries are unnecessary.

Li Jingsheng opened a clinic in the old street in the south of the city. If he didn't have this bit of vision, he would have been unable to continue.

"Is this the so-called expert you invited?"

The patient's father questioned the old man in an extremely dissatisfied tone.

"Correct me, I'm not an expert. I just heard about Dr. Shao and came here to do my little bit out of sympathy. It would be best if I could help find out the cause of the disease."

Li Jingsheng looked at his family members and said with a serious face.

"You're so young, aren't you a student in a university? I firmly refuse to use my daughter as a guinea pig."

The family members are still deeply dissatisfied.

"You're joking. I've been working for several years. And I just came here for a consultation, and it won't cause any harm to your daughter." Li Jingsheng dealt with this kind of family members very easily.

This kind of family is actually not a difficult type.

He was full of distrust and anger towards doctors because his daughter was treated by a doctor for a minor cold and turned into a psychopath.

"Doctor Shao, take me to see the patient first! Can the child communicate normally now?"

"Communication is a little difficult."

Shao Bing glanced at the family members following him in fear.

While speaking, the two had arrived in the reception hall of the emergency department.

I saw a five-year-old girl lying on a pushable flat bed, and a 27-[-]-year-old woman stood beside her, her expression sad and full of worry.

Look at the situation, most likely the mother of the child.

"It's this little girl. Her current main symptoms are vomiting, nausea, and delirium. Her face seems a bit stiff and she can't show her expression. Even when she is in pain, her facial expression is not obvious."

Shao Bing mainly introduced the patient's condition to Li Jingsheng.

The patient was lying in the reception hall of the emergency department, which means that he was not admitted at all.

There are many similar patients in the reception hall.

Either waiting in line for a doctor, or can only rent a temporary flat bed with four pulleys for the patient to lie on.

In the unlikely event of an emergency, the doctors and nurses will not be desperate to save them in the hospital.

Some first aid will certainly be given.

Li Jingsheng has also been to the People's Hospital. Compared with the ruthlessness of the Qiaobang Hospital, the People's Hospital is much warmer.

Although there are some patients who are unwilling to be admitted to the hospital, there are not so many.

Moreover, there will be more or less specialized medical staff to patrol and provide necessary help and supportive treatment to patients.

In the emergency hall of Qiaobang Hospital, it can be clearly felt that some patients are ignored by the medical staff.

Either it cannot be cured and the patient is advised to go to another hospital for diagnosis and treatment, but the patient refuses.

Either the patient has no money to pay the hospital bill.

Either the condition is not obvious and there is no way to confirm it.

In short, there are various reasons.The number of patients who are neglected in this part is a bit large.

This has something to do with the hospital's rules and regulations, as well as admission standards.

"Kid, have you had dinner yet?"

Li Jingsheng greeted the little girl gently.

"Ate a little, but spit it all out."

The girl's mother replied next to her.

"If you can't eat, you still need to ask the hospital for some glucose nutrient solution to support it! The child is so small, how pitiful!"

Li Jingsheng said this not only to his family members, but also to Dr. Shaobing.

Although Shao Bing used to be a famous doctor in Qiaobang Hospital, now he can't even get a hospital qualification.I don't know if it's because he didn't do well in the past, or if his former colleagues were too cold and heartless.

"There is support for infusion of nutrient solution for the child! At present, we have tried to find out a variety of causes. Systemic lupus erythematosus, syphilis, fibromyalgia syndrome, and rat-bite fever have basically been ruled out. Tuberculosis is being screened, and tomorrow should It will produce results."

Shao Bing said to Li Jingsheng.

It seems that the hospital did nothing to keep the child here.

It's just that according to the regulations of the hospital, there is no way to admit him to hospital.

The main reason is that no doctor dares to take over easily.

It is not easy to find a job as a doctor in Qiaobang Hospital, which is equivalent to being killed by thousands of troops.If a job is lost because of a moment of kindness, this loss is a loss that no doctor is willing to bear.

understand.

Li Jingsheng reached out and touched the little girl's forehead.

"It's a bit hot! The body temperature should be fever?"

"Yes, it's hovering around 37.5 degrees."

Shao Bing nodded in confirmation.

"Mother of the child, can I check her lymph nodes?"

Li Jingsheng consulted the mother of the child.

The child's father is a bit vicious, and he looks very awkward, so it's better not to ask him.

The child's mother turned to look at her husband.

After getting her husband's consent, she agreed.

"Okay. Please be careful not to hurt the child."

"I will be careful."

Li Jingsheng nodded in agreement, and began to check the little girl's lymph nodes.

Mainly the neck and armpits.

"Her lymph nodes are a bit swollen! Her neck is also very stiff."

Li Jingsheng frowned slightly, and he also found a red spot on the back of the little girl's neck.I remember there were red spots on my face, but now I can't see them.

As for other parts of the body, given the cold look in the child's father's eyes, it would be better not to check her chest and abdomen.

After Li Jingsheng finished the inspection, he walked to the convenience counter and squeezed a little disinfectant to clean his hands.

No one knew the little girl's illness. Although syphilis had been ruled out, it was a doctor's habit to squeeze some disinfectant to clean hands after examining patients.

"Who usually takes care of the children?"

After Li Jingsheng's inspection, he already had several doubts in his mind.

Erythema is still regarded by him as the biggest diagnostic breakthrough direction.

"Her father and I usually take her with us."

"Did the child appear abnormal a week ago?"

"Correct!"

"I mean, were there any abnormalities two weeks ago, or even a month or two ago?"

Li Jingsheng asked.

"This...it's nothing unusual. There was only one time when we took her back to my hometown to see her grandparents. She stayed there for two days. After coming back, the child always complained that her body was itchy. After I checked her, I found that there was a There are two small red bumps on the neck, as if bitten by mosquitoes. The child’s grandparents live in mountainous areas, so there may be a lot of mosquitoes.”

After thinking about it for a while, she provided a new clue.

Li Jingsheng nodded.

After listening to the child's father, he was a little unhappy and said, "It happened more than a month ago. What does it matter if I was bitten by a mosquito? I was bitten every day when I was a child!"

"We as doctors only ask about the past medical history, which does not mean that we use this as an important basis for diagnosis. You don't have to do this. Besides, I believe you must hope that we can find out the cause of the child's illness as soon as possible and cure him. ,right?"

Li Jingsheng felt that the child's father was a bit extreme and stubborn.

I don’t say it’s good or bad, at least this kind of thinking can easily go to extremes.

"Doctor Shao, you also heard it just now. The child was bitten a month ago, and now he has symptoms such as fever, swollen lymph nodes, nausea, and vomiting. Do you want to check for scrub typhus?"

A disease popped up in Li Jingsheng's mind.

The child's various symptoms and medical history are consistent with scrub typhus.

The incubation period of this disease is as short as five or six days, and as slow as 20 days or more.

"I also thought of this disease, and immediately tried to find a way to have the hospital investigate it."

Shao Bing's internal medicine skills should be quite solid.

Experience.

After listening to the patient's mother's description, I thought of going with Li Jingsheng.

"Is my daughter's disease really related to mosquito bites? What is scrub typhus?"

When the child's father heard that the two doctors thought of scrub typhus, he couldn't help but come over to ask about the situation.

It can be seen that he is actually very concerned about his daughter's condition.

"Scooty typhus is not a mosquito bite, but an acute infectious disease that occurs after being bitten by chigger larvae carried by mice and other animals. The incubation period is slow, almost exactly more than 20 days, close to a month. So I think It is very necessary to investigate the possibility of this disease.”

Li Jingsheng explained patiently to patients.

"It seems that Shao Bing didn't ask you to help me casually. You still have some skills."

The man couldn't help but look at Li Jingsheng.

It's just that there is still some arrogance and arrogance in the tone of speech.

An ordinary person should not talk to a doctor like this.

If you want to become a qualified regular doctor, you need to study medicine for at least five years.

Many people have studied hard for seven or eight years, or even longer.

Then you have to go to the hospital to receive the second training, which usually takes about three years in a large hospital.

Only by passing numerous examinations and assessments can one obtain qualification certificates such as a medical license, training completion certificate, and graduation certificate.

The little girl's father is a complete layman in the medical field.

It is impolite to judge a professional doctor face to face in such a tone.

Li Jingsheng didn't talk to him any more, but thought about the doubts further.

First of all, the fever of scrub typhus is generally very urgent, and the body temperature rises rapidly, usually reaching a high temperature of over 39 degrees.

This little girl belongs to moderate fever, and the onset is relatively slow.

This is somewhat inconsistent with scrub typhus.

Second, scrub typhus will produce eschar, which he has not seen in the little girl for the time being.

Third, scrub typhus may occasionally appear erythema, but it will not migrate away.

When Dr. Shao took the video to Li Jingsheng, red spots could be seen on the little girl's face, but now she can't see it.

Instead a red spot was seen on the back of the neck.

This remains a major doubt.

Dr. Shao Bing is already calling to find an acquaintance to help the little girl with scrub typhus.

"Mother of the child, can I check her upper body and calves?"

Li Jingsheng asked the little girl’s mother.

"Okay, please take care."

The child's mother did not ask for her husband's opinion this time, and agreed directly.

And took the initiative to lift up the child's shirt to cooperate with Li Jingsheng's inspection.

It seems that Li Jingsheng has just shown a little bit of ability, which has made a new breakthrough in diagnosis, and the family members have placed great hope in him in despair.

The child's father is holding the mobile phone as if searching for something.

It is estimated that most of them are using the Internet to popularize information about scrub typhus.

After Li Jingsheng examined the little girl, he found no eschar, but instead found several erythema.

It seems that the possibility of scrub typhus is low!

Since it’s not scrub typhus, what kind of disease is it?
Rabies has been screened and basically ruled out.

At the level of Qiaobang Hospital, the tests are still very authoritative, and the possibility of errors is extremely small.

There is a chance of missed detection, but it is very low.

Moreover, after the onset of the disease, symptoms such as hydrophobia and screaming will appear, but the little girl does not have these symptoms.

Therefore, rabies can no longer be considered.

The initial symptoms were like a cold, but on the third day after the treatment, it turned into a neuropathy and started to go crazy. This kind of disease is really rare.

"Dr. Shao, have you checked the child's CSF?"

CSF biochemical examination is cerebrospinal fluid examination, which requires puncture.

"The family members haven't agreed yet."

Shao Bing replied somewhat depressedly.

If the family members do not agree to do this kind of risky inspection, there is no way at all.

"Family, why don't you agree to have a cerebrospinal fluid biochemical test?"

Li Jingsheng looked at the father of the child who was bowing his head to popularize scrub typhus knowledge.

"I checked on the Internet, and it was said that a lumbar puncture was required for this examination, which might lead to disability. There were also people who died directly because of this examination, so I did not agree."

The child's father spoke plausibly.

"Then there are still people who choked to death eating dates! Don't you eat dates now?"

"Anyway, I'm just worried about the danger, and I don't dare to trust you doctors so easily."

The child's father has his own set of ideas.

"I think it is necessary to check CSF, because based on the child's current symptoms and physical examination, the possibility of scrub typhus is low. It may be some rare diseases. The sooner it is detected, the better for the child. Procrastinate As time goes by, even if the cause of the disease is found, the child's brain and nerves will be seriously invaded, or the disease will be irreversible, leaving serious sequelae.

The child's life will be ruined. "

Li Jingsheng even used some coercive language techniques in order to persuade the family members to agree to let the child undergo the examination.

"If my child is ruined, I will let this quack doctor pay for it! I will let his family be ruined."

After the child's father heard this, he lost control of his emotions and became extremely irritable.

Doctor Shao Bing was scared and hid behind him.

He looked at Li Jingsheng with pleading eyes, hoping that Li Jingsheng would stop using these irritating words to stimulate family members who are prone to going crazy and losing control.

"This result could have been avoided! You listen to me now and agree to let the child undergo this examination. I dare not say that the cause of the disease will be found out, at least there will be a greater breakthrough. Personally, I think it is very possible to find out the cause of the disease directly. The possibility is extremely high. Judging from some of the child's current symptoms, the progress of the disease should have reached a critical period, and the cause must be found out as soon as possible to prevent it from continuing to progress."

Li Jingsheng is not afraid of family threats.

In fact, it is impossible for the family to do anything to him.

"What if it doesn't stop?"

the child's mother demanded.

"The prognosis is likely to be poor."

Li Jingsheng told the truth.

"Does prognosis mean sequelae?"

"Almost! It refers to the state of the patient after being cured."

After hearing this, the woman looked at her husband.

"Husband, let's agree to do this examination! My daughter's condition is getting worse day by day, and I feel really bad when I see it. I think Dr. Li speaks very straightforwardly, so he doesn't need to lie to us."

"What if something goes wrong?"

"There will definitely be accidents if you don't treat it, at least there is hope if you cure it!"

The wife appears to be much more sensible than the husband.

The husband was still hesitating. After a long time, he looked at Li Jingsheng, "I'll just trust you once. If you dare to lie to me, I'll do it with you."

Li Jingsheng was sweating profusely.

"If you say that, then I won't care about it. Treat whoever you want to treat."

After speaking, Li Jingsheng looked at Dr. Shaobing.

"Doctor Shao, we doctors are not anyone's slaves. We practice medicine legally. There is no need to compromise blindly. If we encounter unreasonable family members, we just go through legal procedures. The more we give in, the more reasonable it becomes. No reason."

After he finished speaking, he really let go of it.

Which doctor would dare to take care of such a mentally ill family member?
There is a reason why little girls are not admitted to institutions if they are not straight.

The doctors and nurses saw the family members with thorns all over their bodies, and no one wanted to provoke them, they only wanted to persuade them to leave.

After the patient's father was scolded, he was very angry at first.

However, I may feel that what Li Jingsheng said is reasonable, his expression has somewhat changed, and the fierceness and madness in his eyes have also lost a lot.

In this world, who is afraid of you going crazy?

After all, he wanted to save face. Even though he knew he was wrong, he was too embarrassed to lower his head.

Can only look at his wife.

He has a good wife who understands her husband's eyes and thoughts at a glance.

"You, you, everything is fine, but it's bad to try to solve everything with your fists. Finally, a doctor who is sincere and helpful came. You scared him away. What about your daughter's illness?"

"I'm...in a hurry too!"

The man was extremely ashamed by his wife's scolding, and his tone of voice became much softer.

She ignored her husband and chased after Li Jingsheng.

"Doctor Li, Doctor Li, my husband said something wrong just now, I apologize to you, please don't argue with him? I promise you, I will never let him threaten you again. "

"No need to apologize. If you are willing to listen to my advice, just agree to let the child do the CSF biochemical test. When the results are available, let Dr. Shao Bing send them to me. As long as it is within my ability, I will definitely actively Help with the diagnosis. I guess after the test results come out, the cause can be found without my help."

Qiaobang Hospital is full of experts. As long as there are test results, the doctors here will definitely be able to find out the cause.

Li Jingsheng waved to the female family members.

Coming here to help with the consultation, being treated like this must have made him angry.

However, this matter was originally agreed to make Boss Zhao owe a favor.

When people come, strength comes out, so naturally it doesn't matter.

"I don't think your daughter has scrub typhus. Let's see when the test results come out! I found that your biggest problem is that you don't cooperate with the doctor. This is very bad. I suggest you stop confronting the doctor. The doctor wants the patient more than you. get well soon."

After saying that, he didn't stay any longer and went straight away.

Back at the clinic, he was reading medical books after taking a shower, when Dr. Shao Bing called him.

I glanced at the time, it was almost 24 o'clock.

"Doctor Shao, hello!"

"The test results are out, out!"

Dr. Shao Bing was very excited and incoherent.

"Talk slowly, is it not convenient for your family members to stare at you again?"

Li Jingsheng hated family members like the patient's father.

Threats to the doctor at every turn, shouting and killing, who do you think you are!

(End of this chapter)