The Enhanced Doctor-Chapter 647: Irreconcilable contradiction

"President Liu, what's going on? Weren't we supposed to keep her in the hospital for observation? Has she really been diagnosed?" Wang Huan couldn't hold it in any longer when he saw Liu Lu and Wang Xiaoyan happily leave.

"She's been officially diagnosed with bulimia—a series of symptoms triggered by induced vomiting. It can't be effectively treated in the hospital. It's not severe right now, so let her go home and try to manage it," Liu Banxia said casually.

"Uh... so it's that. It's... it's rather unexpected," Wang Huan said, taken aback for a moment, his tone full of emotion.

"We kept trying to diagnose it as something else, which is why we ran into so many contradictions and couldn't find a lead," Liu Banxia said.

"Bulimia isn't actually very common in daily life, and it's even rarer among affluent people in big cities."

"Why's that?" Xu Yino asked.

"Because bulimia is often accompanied by a certain degree of stress. Eating provides a certain sense of satisfaction, which then leads them to eat more and more, I suppose," Liu Banxia said with a smile.

"However, like anorexia, it's an eating disorder. The triggers are numerous and often elusive. It's more often neurological, I believe, and patients can only overcome it slowly on their own."

"In this regard, medical conditions in our country are still somewhat lacking. It should be supplemented with psychological counseling to help her sort out her thoughts. Only then can she gradually break this habit."

"Staying in our hospital is pointless; it would only make her more stressed. The more anxious she becomes, the worse her condition will get. Didn't you see? She was starving at lunchtime but didn't eat anything."

"Teacher Liu, is that how you noticed it?" Huang Bo asked curiously.

Liu Banxia nodded. "That was part of it, yes. Anyway, I love to eat, and I feel awful when I'm hungry. Since we couldn't find any signs of organic lesions, I had to look for contradictions."

"She had no acute or chronic diarrhea, and her diet was still normal, yet she's losing weight so quickly now. She should be eating but isn't. What else could it be? It's not that she doesn't want to eat, but rather that she's afraid something will happen after she eats."

"Patients with bulimia often show signs of receding gums or enamel damage. Some also have scars on their hands, caused by their teeth when inducing vomiting."

"Once I saw the condition of her teeth and some scarring at the back of her throat, I was pretty certain. However, this matter needed to be handled discreetly, so I could only discuss it with her in the examination room."

"You all should pay attention to this. We doctors might consider some conditions to be quite common, but from the patient's perspective, they can be a very big deal."

"So, in this regard, we must always prioritize protecting patient privacy and not just casually disclose their condition. Doing so can affect the patient's emotional state and make future treatment more challenging."

"If we had a psychologist here, we could refer her directly. With a psychologist's intervention, I believe her chances of recovery would be higher."

"Forget about that pipe dream. How much would that increase costs? Besides, it's difficult to determine the fees. The competent ones open their own clinics, and we can't use those who aren't competent," Wang Huan said with a laugh.

This wasn't the first time Liu Banxia had brought this up; he had previously mentioned post-prognosis psychological counseling for some patients too. For instance, the patient with necrotizing fasciitis on their finger, and the patient who underwent an abdominal foster transplantation.

It's a good idea, but the cost is somewhat high. The hospital needs to cover its expenses, and psychologists' fees are also quite high.

"Teacher Liu, so how did you explain it to the patient?" Xu Yino asked curiously.

"All I could offer was encouragement, helping the patient believe she could do it," Liu Banxia said.

"What other way is there? Ultimately, she has to overcome it herself. It's difficult to talk about this illness with family and friends; otherwise, it's easy to draw strange looks."

"So, that's the situation. There's also some good news you all might already know: our Teacher Wang Chao's fecal transplantation has achieved initial success."

"From what we've seen so far, the patient's condition has greatly improved, proving this approach is very feasible. If anyone wants to follow in Teacher Wang's footsteps, you can sign up."

"Sigh... I have to go to the ICU tomorrow. I need to prepare well," Xu Yino said before leaving.

"Pediatrics... the number of new young patients has increased. It's a bit of a worry," Miao Rui muttered.

"I'm in the next wave. Li Hao, let's go draw lots," Huang Bo said.

"Okay, otherwise we'd both have to compete for it." Li Hao nodded seriously, then went off to the side with Huang Bo.

"These guys, have they gotten so mischievous now?" Liu Banxia said helplessly.

"Well, what can you do? Just look at who they usually learn from," Wang Huan said with a smile.

"Sigh... let's not think about it for now. We'll see then if any of the interns are interested in this," Liu Banxia sighed.

"I reckon if this patient of ours truly recovers, it'll be like Wang Chao set off a huge firework. More patients will definitely come then, and his 'business' will officially be up and running."

"Then he'll be worried, and I'll be worried too. When patients come, we have to see them; there's no reason to turn them away. This will distract him and consume a lot of his energy."

"Moreover, this treatment method is still in an exploratory stage. Donor screening and storage is also a major undertaking. We need the hospital's support to secure funding for this part."

"The lab working overtime once or twice isn't a big deal. But it can't go on like this indefinitely, can it? Right? We still need to think this through carefully, don't we?"

Wang Huan shrugged. "I have to go see patients."

Seeing only Qing Kewa was left, Liu Banxia asked seriously, "Qing Kewa, what's your opinion?"

Qing Kewa shook her head blankly. What opinion could she have?

"Sigh... go wander around on your own. I need to think about this some more," Liu Banxia sighed.

Actually, he was still hesitant about whether to establish this project. Establishing a new department or treatment program is no easy task. Not all the approved departments in the Emergency Center are even fully operational yet, let alone the fact that fecal transplantation has too many uncertainties. Without sufficient data to back it up, many aspects are still uncharted territory, making it very difficult to implement. Every patient who seeks treatment certainly comes full of hope. If it doesn't work, it's a blow to them, and by then, their feelings about it would be completely different. Besides, this kind of work, fecal transplantation, should normally fall under the purview of internal medicine. Now, by a strange twist of fate, it has landed on Wang Chao. It's uncertain if this will affect his surgical practice in the future.

After some thought, he knocked on Zhou Shuwen's office door. He needed to consult Zhou Shuwen about this matter now and make preparations in advance.

After listening to Liu Banxia's explanation, Zhou Shuwen asked, "What do you think of this project?"

"Director, from my perspective, it definitely has benefits. Not just for our Emergency Center, but for our entire hospital," Liu Banxia said.

"So many people suffer from intestinal diseases. It also shows some efficacy for Clostridium difficile, irritable bowel syndrome, inflammatory bowel disease, metabolic disorders, and autoimmune diseases. Several hospitals in China are already conducting research in this area."

"The reason it hasn't been widely adopted nationwide, I believe, is because this therapy is still in the research phase and lacks a solid theoretical basis. Another factor concerns the patients themselves."

"Because it's still in the research stage, there's no way to guarantee its efficacy. Success often depends more on luck. If there are too many failed cases, it will be labeled a fraudulent therapy, and hospitals are unwilling to bear this risk."

"Patients, on their end, need to consider the cost and their level of acceptance. Many patients harbor various reservations or taboos about it. I don't believe many patients would be able to readily accept this therapy."

Zhou Shuwen nodded. "That's why I'm also hesitant about this. Considered purely from a clinical treatment standpoint, it is beneficial for patients."

"But we, as hospital administrators, need to consider many more factors. A department needs to be profitable. Only by being profitable can it cover its various expenses."

"A portion of the profit also allows us to update equipment and subsidize treatment for patients who cannot pay their fees in full. This is how we ensure our normal operations."

"Otherwise, if patients are brought in for emergency treatment in the future and we lack doctors and medicine, how could we save them? At that point, it wouldn't just affect one or two patients, but many."

"Let's both consider this matter and see if we can come up with a feasible plan. You should also have a good talk with Wang Chao about it. If I were to talk to him, he'd feel pressured and find it difficult to express his true thoughts."

"Director, you've even considered this aspect?" Liu Banxia asked in surprise.

"How could I not consider it? I'm just hoping our Emergency Center can have more profitable departments. The money earned could then help more patients," Zhou Shuwen said helplessly.

"Recently, more news stories have emerged about hospitals 'refusing to treat dying patients.' Sigh... sometimes, it's truly disheartening. It's not that we don't want to save them, but rather that the floodgates cannot be opened."

"Even if we do save a life, we might end up embroiled in lawsuits. The pressure from public opinion is also immense. Who knows when we might face such a situation here."

"However, we don't have that many choices; we have to save the patient first and deal with the consequences later. So, in the future, the deficit in emergency care will only grow, not shrink."

Liu Banxia nodded. This was indeed an irreconcilable contradiction. It wasn't enough to just treat illnesses and save lives; they also had to make money. One could imagine the immense pressure Zhou Shuwen was under every day. The Emergency Center needed achievements, and these achievements weren't solely a measure of medical capability.