I run a clinic in the United States

Chapter 318 The third tradition begins with Nanako

It was said that the wind was beautiful and the sun was shining brightly. Chloe thought that this beautiful Chinese doctor was asking her to go outside for a walk, breathe fresh air and enjoy the autumn sunshine!

Who would have thought that he was actually going to pee on the air?

This is the first time she has heard of it.

Even Dr. Vivica has never heard of or seen anything in her nearly twenty years of primary care practice.

Because Vivica had always been in grassroots clinics, dealing with minor illnesses.

In most clinics in the United States, when encountering slightly more difficult and serious diseases, the answer is just one word: referral. Simple and crude.

This is caused by the hierarchical diagnosis and treatment system and the two-way referral system in the United States, and it is also a routine operation.

However, Iris Clinic is a special case. Here, there is no such thing as referral. Because there are top-notch all-around famous doctors here.

Not making referrals is also the "tradition" of Iris Clinic.

"Do you really want to show your urine? Dear Chinese doctor!" Chloe thought this was Chinese magic.

This mysterious Eastern country has many magical medical technologies, such as inserting steel needles all over the body.

Come to think of it, the same goes for drying urine.

Chiba Nanako shook her head and said seriously: "I am not Chinese, I am Japanese, from Tokyo, and graduated from the University of Tokyo."

"Oh~" Chloe felt like she suddenly realized something, but then she became confused again and blurted out, "Isn't RB a state in China?"

At this time, not only Chiba Nanako was speechless, but Dr. Vivica beside her also covered her forehead, with the same expression as Rachel before.

Vivica was relieved and comfortable, and said to herself, I just couldn't tell the difference between Koreans, Japanese and Chinese before, but I didn't expect that this Chloé didn't even know the country RB.

It seems that this is not my fault alone.

In fact, the United States is the world's hegemon. Americans, like China in the late Qing Dynasty, are arrogant to the core and lack relevant education and learning. They will not pay attention to other small countries.

Chloe is a product of happy education. After graduating from middle school, she started selling burgers in a burger shop. Although she has heard of China, she really does not know the relationship between RB and China, nor does she know where the capital of China is.

Chloe looked confused and said suspiciously: "Tokyo? Isn't it the capital of China?"

Chiba Nanako told her seriously: "BJ is the capital of China. RB is a country on the edge of China."

"Okay, forgive my ignorance." Chloe shrugged, then touched her belly and said with a smile, "My abdominal pain seems to have subsided after you guys did this."

Vivica held her stomach and shouted, "My stomach hurts a little." She couldn't help but laugh!

Chiba Nanako spread her hands: "Then go and pee quickly. Ask Ava to get two disposable cups. Divide the urine into two parts. One part is placed in the sun and the other part is placed in a cool place in the clinic as a control. "

"Okay." Chloe hurriedly went out. She was also very curious whether the operation of drying her urine could help her find out the real cause of the disease. She was really tortured by the constant abdominal pain.

"Pee?"

Ava looked surprised and handed Chloe two transparent disposable cups. Then, when Chloe finished taking the urine and came out to dry it, she watched from the side.

After Rachel and Dr. Yenard heard about it, they also came out to watch with Vivica.

"How long does it take to stay in the sun? Is it a color change? Or is there any precipitation? Or smell?"

"I don't know, Dr. Chiba Nanako didn't say anything."

Chloe filled two large cups, because the sun was strong outside, and she was afraid that they would dry out in a while. So the quantity is quite sufficient.

I have to say that fresh urine is yellow and crystal clear under the sunlight. It is quite beautiful, but it has a strange smell.

Since Chloe was still in pain, Vivica took her to the infusion room for infusion, and first treated her with symptomatic treatment to relieve the pain.

Everyone else also dispersed. After all, it was just a cup of urine, left to dry in the sun. It felt fresh at first, but it was just like that after looking at it for a few seconds. It's impossible to stare at it all the time, and it's not a good drink.

About an hour and a half later, Murphy and Elena came back from the community hospital. When they entered, Elena noticed the urine not far from the door, took a look at it, and said to Murphy: "Why is there a cup of yellow here?" Yellow liquid? It looks like urine."

After taking a closer look, I was sure that the strange smell was definitely urine. I couldn't help but get a little angry and shouted: "Who is so low-quality? Leave urine at the door of the clinic."

Chiba Nanako heard it and hurriedly came out to explain, but Ava got there first.

Because Ava was reading in the rest area, so close.

Ava said: "This is a patient peeing in the sun. This place has good sunshine, and other places are blocked by the shade of trees. It was Chiba Nanako's suggestion."

"Pee?" Elena was also confused.

Murphy was thoughtful, then nodded and said, "Is this suspicion of porphyria?"

Chiba Nanako, who walked out later, couldn't help but glance at Murphy in surprise, and thought to herself, this little iceberg beauty has some skills and can see through my intentions.

Before Murphy, no one else knew.

Now that Murphy has approved it, Elena will naturally not care too much. The group of people will return to their posts and perform their duties.

About half an hour later, the black girl escorted Stephanie back in her car.

After parking the car, the two of them got out. Stephanie took out ten US dollars worth twenty yuan and gave them to the black girl.

"This is too much, Doctor Stephanie." The black girl said politely.

"Not much. Thank you for your hard work this time. Without you, I don't know what I would do." Stephanie thanked her.

Because on the road, there was a homeless man who saw that Stephanie was beautiful and had a hot figure, so he couldn't help but come forward to harass him. Then the black girl took action and taught him how to behave.

He didn't hit hard, he just broke one of the opponent's legs and two ribs.

There was no way, the black girl had tried her best to restrain herself, and didn't even use a dagger or gun.

"This is what I should do." The black girl was very happy and accepted it, "Dr. Stephanie, I won't send you in. Call me next time if you need it."

The black girl turned around and wanted to go back to the laundry. Then her nose was sharp and she smelled a strange smell. She couldn't help but sniffed and followed the smell and looked over.

Seeing this, he immediately became angry and cursed loudly: "Who peed here and left it to dry in the doorway?"

He thought that within a kilometer of the surrounding area, who didn’t know that this is the territory of our laundry, and that the Iris Clinic is Dr. Zhou’s place? If you cause trouble here, are you seeking death?

Dr. Vivica just came out to make coffee. When she heard this, she immediately put down the cup and ran out to explain: "This is a patient being examined. Don't kick it over."

She was worried that if she ran too slowly, the hot-tempered black girl would kick her over. Then it's all in vain, it's been in the sun for so long.

Chloe, Ava, Elena, Murphy, Chiba Nanako and others also came out one after another.

Chloe had just finished the infusion and was much better now. She was resting in the rest area. She was supposed to come out from time to time to take a look, but she didn't because she felt unwell.

At this time, Chloe shouted: "I was the one who dried the urine. Dr. Chiba Nanako told me."

She was very afraid of this black girl, she was too fierce, but when she thought that this was the arrangement of the clinic, she suddenly felt confident.

"Showing your urine?" The black girl looked even more confused, wondering, do white people also have such bad tastes?

How disgusting!

"I'm sorry, I didn't know." The black girl was disgusted and a little ashamed, but fortunately she didn't kick her over.

Chiba Nanako looked at Stephanie. Because Murphy had seen it before, Chiba Nanako thought to herself, I wonder if this girl with a hot figure can see it?

Murphy also glanced at Stephanie.

Stephanie was proficient in psychology and noticed the look in Chiba Nanako's eyes and the vague look in Murphy's little Bichi eyes. How could she not know that these two chicks wanted to "provoke" her secretly, so she immediately smiled. Said: "Is this suspicion of porphyria?"

Vivica, Chloe, and Black Girl have been talking about it for so long, and she has long thought about the reason.

Dr. Vivica: "..."

I'm almost depressed. Why are these young girls so high-level? Anyone who comes over can see it? Is she an idiot?

Rachel was also ashamed, but also admired.

Chiba Nanako gave a thumbs up, gave Stephanie a thumbs up, and said, "Yes, consider pryanx. Look at the time, it will be soon."

"Well," Stephanie nodded and said, "This disease is indeed quite rare, and you are also quite powerful!"

The two "complimented" each other, Murphy blinked and took Elena back to the consulting room. In fact, at this time, the urine that was originally yellow and clear like beer had changed a little. After about half an hour, Chiba Nanako came out to check and saw that the color had turned deep red, like red wine, and she left it in the clinic. The cup under the bathroom cabinet is still yellow.

Chiba Nanako nodded, knowing what was going on.

Porphyria is basically diagnosed.

Chloe, Vivica, Rachel, Jenard, Ava, Elena and others came out to watch, and they were all amazed.

Nanako Chiba explained to Koyi that porphyrin is the raw material for the synthesis of heme in the human body. Porphyria is caused by the lack of a specific enzyme during the synthesis of heme, resulting in the excessive accumulation of porphyrin and porphyrin precursors. , thereby causing a heterogeneous group of diseases.

Porphyrin precursors are neurotoxic, so the main clinical manifestation is nervous system involvement.

Among these symptoms, the most common is acute intermittent abdominal pain, with an incidence rate of about 90%. The location of the pain is variable and the time varies. In severe cases, it can lead to intestinal obstruction, just like Chloe.

The reason for drying urine is that porphyrin is almost the only endogenous photosensitizer in the human body and has a special absorption spectrum.

After porphyrin and its derivatives absorb light, they are activated to emit red fluorescence, among which uroporphyrin has the strongest light sensitivity.

Urine containing porphyrins stains like red wine when exposed to the sun, and some people mistakenly think it is hematuria, but it is not.

"That's it! You are so amazing, Dr. Chiba Nanako!" Chloe raised two thumbs up to express her gratitude.

Later, Nanako Chiba arranged genetic sequencing for Chloe. However, the test took time and did not come out so quickly, but it was almost the same.

……

Murphy and Stephanie also came out to take a look. They both looked at the new doctor from the University of Tokyo School of Medicine and initially accepted him.

Well, you don’t have any ability, so you are not qualified to be our sister.

They knew that Zhou Qiao would definitely eat a beauty like Chiba Nanako.

Having been with Zhou Qiao for so long, they still don’t know what Qiao is thinking? There are no young and beautiful beauties brought back for nothing.

In fact, Utah in the United States supports polygamy. In Utah, it is not surprising that some people marry more than a dozen wives.

As long as you have the ability, you and I are willing, and no one can interfere. Others can only envy you.

And Utah is not far from California. California’s neighbor to the east is Nevada, and further east is Utah. The next door, which is equivalent to the next door, is not a remote place, but the core hinterland.

Even in states that do not support polygamy, private multi-person movements are common.

In the love life of many Americans, especially young people, there is this rule: If you love her (him), you should let her (him) do whatever she (he) likes to do, instead of stopping her (him). ), causing her (him) to lose the joy of experiencing adventure.

As for middle-aged men or women, it’s not that they don’t have this concept, it’s that they have experienced everything they should have experienced, so they are not that interested anymore.

Since polygamy was suspected of "setting back history," the U.S. government was initially opposed to it and even sent troops to suppress it. As a result, once the army passed, many soldiers joined the other side and enjoyed the "benefits" of polygamy there. This matter is over.

After all, public opinion cannot be violated.

According to statistics, 40% of customers for adult toys or videos in the United States are women.

In addition, in the United States, there is also an Oscar ceremony for adult videos. There is a legitimate magazine there with great influence, called AVN for short. Its main content is to rate adult videos and write film reviews.

Just by reading this magazine, you can know which small film is selling well and which small film is rubbish.

Every year, AVN will host and sponsor the annual Adult Video Industry Awards Ceremony in Las Vegas, USA, based on the Oscars.

The various protagonists and supporting characters in the film, dressed in suits and beautiful evening gowns, attended this grand ceremony. Many media also came to interview and report.

This is all legal and legal, and there are a series of awards, including Best Actor, Best Actress, Best Supporting Actress, Best Screenplay, Best Director, Best Film, and Best Gay Scene. Best Multiplayer Award, Best Newcomer, Best Non-Pro...

There is also a complete red carpet ceremony, a trophy like the Oscars, and the budget is definitely higher than that of any local Chinese Spring Festival Gala.

All in all, it was quite grand, high-quality and not shabby at all.

There is an award-winning actress who once ran for Congress, yes, the United States Congress.

Someone warned her that politics is a big game. With your status, you should think carefully about it.

The actress proudly retorted: "I only know one thing. The dirty and despicable politics are far beyond my job. I am always ready to challenge!"

Having seen so many scenes of them naked, and then attending such an occasion, I felt a very strong sense of dislocation in time and space.

Well, Elena and Ava are also loyal buyers, and there are still a lot of items not suitable for children on the third floor of the clinic.

The new house has been ventilated for several months, and the formaldehyde has almost dissipated. They plan to move in and officially move in.

Then, both Murphy and Stephanie came over to help pack their luggage. Elena and Ava didn't shy away from them, they packed it openly and even played with it to tease Murphy.

For example, when Elena saw that Murphy found a sexy little piece of clothing, she strongly suggested that she wear it for everyone to see, saying that this dress was particularly suitable for Murphy's figure and showed off her skin.

Murphy blushed at the fuss, but Stephanie was not surprised and said to herself, "I've known it for a long time, there are more exciting toys here."

When it comes to knowing how to play, Elena has to be the best. Even Stephanie, a promiscuous witch, can't compare to her.

Murphy had fantasized about being with Elena and Ava, but if Stephanie joined, she would definitely refuse.

I have to say that Elena and Ava are very popular.

……

We just have fun in private, but everyone is still very serious and dedicated in their daily work.

Zhou Qiao is very strong, and several girls cannot live without him, and they have never considered cheating. Because after getting together with Zhou Qiao, I have no interest in other men at all.

When the genetic test results came out, sure enough, Chloe was suffering from porphyria.

Chiba Nanako called and informed Chloe of the result and asked her to come over for review.

During the re-examination, Chiba Nanako explained the condition to Chloe and told her that drinking, infection, mental stimulation, surgery, menstruation, low blood sugar, etc. are all causes of porphyria, and she should pay attention to it in the future.

As for the treatment method, it is very simple. It is to use large doses of glucose every day to reduce the production of porphyrin precursor substances, and to avoid triggering factors.

As menstruation is unavoidable, you can increase your glucose intake during menstruation.

Chloe bought a lot of glucose preparations or drinks and drank a little every day. She never got sick again after that. Moreover, she especially liked to eat sweet things. In the past, she was afraid of getting fat and didn't dare to eat. But now she's fine. The doctor said, don't worry about eating. In her situation, her blood sugar won't spike.

Of course, regular review and physical examination are also very important.

Chloe has naturally become a loyal supporter of Iris Clinic.

The abdominal pain that had been bothering Chloe for several months, and the strange disease that could not be found out after many tests, were easily diagnosed by Chiba Nanako. It must be said that Chiba Nanako's level is very high.

For this reason, Vivica, Rachel, Jenard and others were shocked by Chiba Nanako and put her in the same position as Murphy and Stephanie. What incurable diseases will happen in the future? , if Murphy and Stephanie are not around, they will ask her for advice.

There is no way, Dr. Zhou said, our Iris Clinic does not make referrals.

Referral? Dr. Zhou cannot afford to lose this person.

Not making referrals is one of the traditions of Iris Clinic, and team building is the second tradition. When encountering unexplained abdominal pain, the first thing to do is to urinate and bask in the sun, which is the third tradition of Iris Clinic.

After that, whenever new people came in, especially physicians, and encountered unknown abdominal pain, the "seniors" would tell her to ask the patient to take two urine samples, one to be dried in the sun, and the other to be kept indoors in a cool and dim light. as a comparison.

Newcomers are often confused: "Pee?" What kind of sexy operation?

However, it often works wonders.

Later, it has been used ever since.

This third tradition was "created" by the beauty Nanako Chiba. Years later, many people would give a thumbs up when talking about it.

Of course, it was also due to luck and opportunity. Murphy and Stephanie happened to be away, but luck and opportunity are also given to those who have the ability. It is a manifestation of strength.

(End of this chapter)