The Enhanced Doctor-Chapter 594 worsened

"Try giving some fever-reducing medicine and keep the patient in the ward," Liu Banxia said after deliberating for a moment.

Upon hearing Liu Banxia’s orders, Xu Yino quickly ran back. Liu Banxia also shared this information with the small group that had just had a consultation. Was this a new discovery?

Although the patient’s condition had worsened slightly, for these doctors, this development was actually helpful for diagnosis. Most of what they had just discussed could now be ruled out. Regardless of what had caused the patient’s condition, it was still developing. From the current situation, infection seemed more probable. Some kind of infection had likely caused vasculitis, and since the infection was still ongoing, the patient’s condition was worsening.

He now focused on the sinuses. This issue had been considered earlier, but it hadn’t been given top priority. Based on the current situation, it seemed that inflammation in the lungs and sinuses could be keeping the patient’s temperature elevated. This roughly meant that levofloxacin wasn’t working for the patient, so they had to try other drugs. But they couldn’t just try things randomly, as that could harm the patient.

For sinus inspections, the ENT doctors from the inpatient department didn’t need to be called. It was a routine check; they could be called for a consultation if needed.

"Take it slowly. It might be caused by an infection from some particular bacteria. Have you auscultated the patient’s lungs again?" Xu Hui asked as he walked out.

"Yes, we performed it again, but there’s no further progress. The damage to the lungs wasn’t severe yet. Let’s wait to see the results of the liver and kidney function tests," Liu Banxia responded. "The key is the next medication. Levofloxacin seemed useless. We have to wait until this bag is finished and then see the results. Perhaps the drug concentration wasn’t high enough to be effective."

Xu Hui patted his shoulder. The patient’s condition could now be classified as a difficult case. It would be challenging to diagnose it in a short time. They would have to wait and see the results of the bacterial culture. If they could successfully isolate the bacteria, they could proceed with symptomatic treatment. He also leaned towards an infection-caused vasculitis. However, ’infection’ was a broad term; one had to determine the specific type of infection that caused it.

"Brother Hui, considering the current situation, could it be that the patient’s series of symptoms were caused by a certain bacterial infection?" Liu Banxia asked.

"It’s hard to say," Xu Hui responded. "However, I personally lean towards the patient’s cold being a separate issue. Perhaps the cold compromised their immunity, leading to the outbreak of some other infection."

Liu Banxia thought for a moment and nodded. This was also very likely. A cold is a minor illness. Often, it can be overcome without medication, just by drinking some hot water, as the saying goes. Even though the patient currently showed some signs of pneumonia, it wasn’t too severe. The right side, in particular, was very mild, and the breath sounds during auscultation were normal.

After a while, the results of the nasal endoscopy came out. The sinuses did indeed show signs of infection, and part of the nasal mucosa was damaged.

Liu Banxia and the others gathered again; they had to continue the consultation.

"Everyone, share your thoughts. What do you think is going on?" Liu Banxia said with a wry smile.

"I’m out of ideas. We have to wait for the culture results," Chen Xuehai said. "The sinus infection was consistent with symptoms of an upper respiratory tract infection. Otherwise, we might need to consider a bronchoscopy, or even a more advanced fiberoptic bronchoscopy."

"What’s the patient’s current temperature?" Peng Bo asked.

"After administering the antipyretic, it has decreased, but the cough hasn’t improved," Xu Yino quickly responded.

"What about the results of the physical examination?" Xu Guosheng asked.

"Nothing unusual had been found," Miao Rui responded. "There was only a wound on one finger showing some signs of infection, but no suppuration was observed. We also debrided the wound. The patient said they had scratched it some time ago. Currently, after thrombolysis, the patient’s condition has shown some improvement. Oxygen saturation has increased, and oxygen support is no longer needed. The numbness in his face and limbs has also lessened."

"If there were no other leads, and if he didn’t have diabetes, we might have considered the wound on his finger more closely," Xu Guosheng remarked. "Wounds on diabetic patients don’t heal easily, and it’s hard to avoid getting them wet in daily life. Since there was no pus, could we rule it out as a separate issue?"

Liu Banxia nodded. "It looked like it. So, we just have to wait for the culture results now?"

Everyone nodded reluctantly.

The main line of inquiry now pointed towards a series of symptoms caused by an infection, with the crucial step being the isolation of the bacteria. This required time; it wasn’t something where results could be obtained an hour or two after starting the culture. This patient’s condition didn’t meet the criteria for emergency surgery. However, for everyone involved, this actually made them more worried. Emergency surgery was generally about finding and fixing the immediate problem. But infections? They were similar to sepsis; if one couldn’t identify the pathogen, it would remain a persistent headache. Not to mention, this time the infection had also triggered vasculitis, attacking the vessel walls.

But one thing Liu Banxia couldn’t figure out was: what kind of infection could simultaneously attack the brain and lungs? He had been pondering this. Unless it was a systemic disease, but such conditions would typically manifest quickly in liver and kidney function tests. However, the patient had been hospitalized for a considerable time and had undergone two rounds of consultations, yet their liver and kidney functions were still normal. As for the pneumonia symptoms, apart from some coughing and fever, there wasn’t much else. So, was it possible that the patient’s situation was merely a coincidence? That the pulmonary embolism and cerebral embolism weren’t caused by the same infection?

He was so worried, he found himself even more anxious than the patient’s family.

"Teacher Liu, why not take a rest now? Aren’t you still going out with Teacher Wang tomorrow?" Huang Bo approached him.

"I can’t sleep now," Liu Banxia said. "Let’s chat a bit. You heard what Miao Rui said, right? You guys will have to play your detective roles and help me investigate when you go back to school."

"Teacher Liu, this task is quite daunting," Huang Bo said with a wry smile. "Although we know some underclassmen, as medical students, where would we find so much free time?"

"So it’s a very difficult task that must be completed. Didn’t you used to work in the student union? Don’t you have any contacts?" Liu Banxia asked.

"Teacher Liu, that was just in my freshman and sophomore years," Huang Bo responded. "Later, I couldn’t keep up. To graduate, I had to study hard and try to get some scholarships." 𝙛𝓻𝒆𝓮𝒘𝙚𝙗𝒏𝙤𝙫𝓮𝒍.𝓬𝒐𝙢

"Haha, that’s better than me; I never got a scholarship. If you ask me, those who get scholarships are monsters. My head aches just looking at them," Liu Banxia laughed.

"Teacher Liu, actually Su Wenhao got the most scholarships. I think he only got a second-tier scholarship once, right? The rest were all first-tier. Now that’s a real monster," Huang Bo added fuel to the fire.

"Ah..., his family situation is a bit special. You guys probably knew about it sooner than I did, right?" Liu Banxia asked.

Huang Bo nodded. "I guess so, but not too much earlier. We’ve known about his family situation for a long time, but we only learned about him returning home to work more recently. Actually, I think his current choice is great. Working with you, he can learn real skills. In just these few months of internship, I feel like I’ve learned much more than I did studying in school."

"Flattering me won’t do you any good; I can’t buy you chicken legs," Liu Banxia said. "Actually, improving your skills depends on the fundamentals. I’ve always emphasized how important the fundamentals are; this is something I’ve experienced firsthand. Once you have a solid foundation, you’ll achieve more with less effort in your future studies and work. That’s why I suggest you focus on a specific organ system for now, and then expand to other systems later. Although we’re in general surgery and perform many types of operations, if you can truly specialize in one area, it will be very important. This applies whether you’re publishing papers in the future or achieving success in a niche field. But don’t think you can slack off. You’re all mine to mold. Even if I haven’t received your ’pledges of allegiance’ yet, escaping my supervision will be quite difficult."

Huang Bo grimaced; this issue was indeed a perplexing one for all of them. Their work experience here had shown them that their future work would be very demanding. However, they also knew that if they wanted to master solid skills in less time, following Liu Banxia was the right choice. The Emergency Center truly operated on a combined training model. It involved so many departments, not just limited to general surgery. It wasn’t just the variety that made it good; the key was that many different medical areas were interconnected. By now, their reputation had spread throughout the medical school, a fact inextricably linked to the pressure Liu Banxia put on them and his training methods.

"Why the guilty look?" Liu Banxia stretched. "The patient’s situation is in your hands. Let’s see what the culture results look like tomorrow morning. Has the big devil spoken to you?"

When Liu Banxia went back to the rest room, Miao Rui approached Huang Bo.

"He made it clear to me: it’ll be hard to leave the Emergency Center. What do you two think?" asked Huang Bo.

"Surrender, what else can we do?" Li Hao said. "After experiencing today’s consultation, I really can’t bear to leave here."

Miao Rui also nodded in agreement. "Interning with Big Devil Liu is addictive. Even if he torments us a thousand times, we’re still devoted to him like a first love. We can learn real skills here. Who else would trust us the way he does, unless they weren’t on the front lines anymore?"

The other two nodded in unison; that was just how it was. The atmosphere in the Emergency Center was good, and they could learn real skills. This made them somewhat reluctant to leave, afraid they wouldn’t adapt elsewhere.