(Thanks to Jiafeng and Louis Keyi for the monthly ticket encouragement)

The atmosphere in the emergency center was pretty good today, because everyone knew just how much benefit a skilled surgeon could bring to the whole emergency center.

The overall reputation of the emergency center had gone up, and everyone could ride the wave. Naturally, there would be a bit more money, too.

For the emergency center, Liu Banxia was a rising star. As long as Liu Banxia could keep growing steadily, the emergency center’s reputation wouldn’t be bad.

When other doctors also start working harder, and they can have a third and fourth top surgeon, the future emergency center will really be something else.

"Eh? Where did Shi Lei go?" Liu Banxia looked around and asked.

"There’s an acute abdomen patient, diagnosed as appendicitis with peritonitis, they pushed him straight to the OR," Qi Wentai said.

"It really is pretty busy. Looks like Old Chen and the others also have surgery this afternoon. I’ve got to take a break; if there’s another surgery you go up, I’ll stay down here and cover for you," Liu Banxia said.

"That works for me, I really haven’t been operating much lately," Qi Wentai said.

"If there’s an appropriate surgery in the future and I don’t have anything scheduled, I can cover for you guys," Liu Banxia said.

"When I was chief resident it was the same for me. The ward work had to be done, and I still had to scrub in, otherwise your hands get rusty. It’s just that back then I had Shi Lei covering me, you can take it a bit easier."

Qi Wentai nodded with a smile.

This counted as giving him a convenient condition; otherwise a chief resident wanting to get on the table really wasn’t that easy.

"Congrats, even though I only caught the tail end of it," at this time Du Fancheng walked over.

"Thanks. How’s your department been lately, busy?" Liu Banxia asked.

"It’s okay. Our busy time is mainly in the mornings. Routine cases are still mostly chronic ENT diseases in the elderly, not like you guys, so slammed," Du Fancheng said.

"And this is the emergency center, not the outpatient clinic. You get more patients over there. I think this is pretty good, at least it’s not that exhausting."

"It’ll get busy again when winter sets in, there’s another wave of allergic rhinitis patients. The number of rhinitis patients is higher now anyway, it’s just that some of them don’t look that severe on the surface."

"Right, since you mentioned that, it reminded me—how’s that patient with the fungal sinus infection doing?" Liu Banxia asked.

"Still need ongoing treatment. Fungal infections aren’t easy to treat, especially in the sinuses, where the contact time of the medication is very short," Du Fancheng said.

"Right now we’re mainly doing nasal irrigation to keep it as clean as possible and using meds slowly over time. There’s really no other trick. It’s actually harder to deal with than athlete’s foot."

"The increase in rhinitis these past two years is actually related to over-trimming nasal hair. Nasal hair is the first line of defense in the nasal cavity. If you clean it till it’s slick and smooth, sure, breathing is easier, but then what’s left to block bacteria?"

"Aren’t there professional nose-hair trimmers on the market now?" Liu Banxia asked curiously.

"There are, but you have to buy ones with decent quality. And you can’t just rinse them with water and call it a day; they need regular disinfection, too," Du Fancheng said.

"Before I came over here, there was a patient who used one of those. Probably because he didn’t keep it clean enough, it turned into purulent sinusitis."

"If nose hairs poke out of the nostrils, just trim them appropriately for appearance, that’s enough. No need to make it so refined. Overdoing it is bad, it makes the inside of the nose really dirty."

"Sigh... each of us is just good at our own field," Liu Banxia sighed.

This was kind of an occupational habit for doctors: whatever specialty they were good at, that’s what they would naturally talk about.

When he was chatting with family at home and giving them some reminders, he would also talk about some general surgery cases, or cases he’d heard from doctors in other departments, just to make everyone more aware.

"President Qi, in a bit they’re bringing in a car accident patient, chest and abdominal blunt trauma," the triage nurse called out.

"President Qi, if we need to go to the OR, you take it, I’ll keep an eye on things for you," Liu Banxia said.

This was exactly what they’d just been talking about. Now that there was a patient, he could just go straight up.

"Okay. Huang Bo, you do the intake, call the cardiac surgeon," Qi Wentai said.

After speaking, Qi Wentai also changed into a disposable surgical gown, getting ready to receive the patient.

To be honest, Liu Banxia was feeling pretty tired by now.

He’d gotten up in the middle of the night and done such a big operation. He’d originally planned to get a bit of rest at noon, but then Tang Feifei showed up.

Doing the orthopedic reduction for her took another half day of fussing, which was also pure physical labor.

Anyway, he’d already decided: unless absolutely necessary, he wasn’t going to scrub in today, otherwise he’d have to burn through more physical-strength potion. The emergency center was very strong now; having him sit one out wouldn’t be a problem.

"Alright, you go get some rest first, I’m heading back too," Du Fancheng said.

"Okay, if anything comes up just call me. My job is to help everyone solve problems; I’m useless for anything else," Liu Banxia nodded with a smile.

Just then the ambulance pulled up at the entrance, and Liu Banxia saw that the person being wheeled down was wearing motorcycle gear and a helmet. No need to think about it—this crash was probably pretty serious too.

Riding a motorbike is really just flesh wrapped around iron, and dressed this professionally, he probably sometimes plays at a bit of Fast & Furious. It’s just that most of the time, that passion gets beaten by car accidents; even a slight scrape can turn into a major incident.

"Teacher Liu, any other arrangements?" At this time, Xu Yino walked over.

"Nothing much, this afternoon’s been relatively calm. Anyway, Wang Chao will be here on the night shift, so you should be able to get a decent sleep tonight," Liu Banxia said.

"Sigh... if only I’d slept a bit less yesterday, I could have gone into the OR to watch today," Xu Yino said.

"There’ll be plenty of chances later. Watching now actually doesn’t help that much; it’ll be a long time before you can really get involved. This kind of operation isn’t that common, and what you need right now is to build up your basic skills."

Xu Yino nodded, knowing that what Liu Banxia said was true.

"Director Liu, are you busy right now?" At this moment, Wang Huan came out of the internal medicine consulting room.

"Help me keep an eye on things here," Liu Banxia tossed over his shoulder, walking quickly toward Wang Huan.

"A patient we saw this morning, the test results just came back, and they’re a bit puzzling," Wang Huan said.

"A twenty-three-year-old guy, very poor general condition, came in for headache and a cold. According to him, he’s the type that catches colds easily. On exam, his temperature was 39 degrees, had a dry cough, auscultation of heart and lungs—aside from slightly decreased breath sounds in both lungs, nothing else."

"The key thing is the blood work: no obvious elevation in white blood cell count. No runny nose, tonsils are normal, chest X-ray is also normal, no visible lesions."

Hearing this, Liu Banxia’s interest was piqued.

The patient has fever plus dry cough and headache, which sounds a lot like an upper respiratory tract infection, what people commonly call a cold. But if it were an upper respiratory infection, there should be some changes in the tonsils.

Some patients, because of the fever, won’t have a runny nose at first, and that shows up later.

If it’s not an upper respiratory infection, then what about pneumonia? That doesn’t really fit either—the chest film is very clear, just slightly decreased breath sounds in both lungs.

And there’s another rather intriguing point: the patient’s white blood cell count isn’t significantly elevated.

With a fever, you usually see signs of inflammation. Whether it’s upper respiratory or lung, most of the time it shows up in the white count.

Walking into the consulting room, Liu Banxia also saw the patient. He did look in pretty poor shape, occasionally pinching the bridge of his nose.

He did a quick physical exam, and it was just as Wang Huan had described, with no additional findings.

"What do you think? This case is a bit odd," Liu Banxia said.

"I was planning to bring the fever down first, I’ve already ordered blood cultures, and then keep him in the hospital for observation," Wang Huan said.

"His temperature is already quite high now. I’m not sure if this is some kind of viral cold. But that doesn’t quite fit either—according to him, this has been going on for quite a long time, on and off, otherwise he wouldn’t call himself someone who ’catches colds easily.’"

"Young man, do you usually exercise?" Liu Banxia asked.

"Yeah, I do, but less in the past two months—I’m afraid of catching a chill. Colds are so annoying. I didn’t even do well on my final exams last time because of one," the patient said.

"Doctor, do I have some kind of terminal illness? Is it leukemia? They say people with leukemia catch colds a lot too."

"How’s your diet usually?" Liu Banxia continued to ask.

"When I’m not having a cold it’s fine, all normal. Once I catch a cold, I can’t be bothered to eat, everyone says my immunity’s gone down," the patient said. 𝒻𝘳𝘦𝘦𝘸ℯ𝒷𝘯𝘰𝑣ℯ𝑙.𝘤𝑜𝘮

"Given your current situation, I think we should do an HIV screening," Liu Banxia thought for a moment and said.

"It’s not that I’m saying you’ve done anything unusual, it’s just one option to rule out. And based on your symptoms, there aren’t any really clear indicators for it either."

The young man was stunned. "Doctor, I don’t even have a girlfriend yet."

"Exactly, which is why I said it’s just an optional screening," Liu Banxia said patiently.

Even so, the young man was scared out of his wits. Of course he knew what HIV was—how could he possibly have that?

"Don’t worry, it’s just a screening. We’ll get your fever under control first, then admit you. We need to figure out why you catch colds so easily," Liu Banxia said.

Ding! Task issued: Patient with frequent colds

Open-ended task: Patient reports frequent colds; symptoms don’t fully match upper respiratory infection or pneumonia and show conflicting indications. The host needs to perform further examinations and confirm the diagnosis. Task reward: to be granted according to diagnostic result.

The young man was still somewhat frightened and resistant. But he nodded anyway—what if? What if he really did pick something up somehow?

"Do you think it’s possible? I didn’t feel any lymph node enlargement on exam," Wang Huan asked with a frown.

"I’m not sure either, this is just to be on the safe side," Liu Banxia said with a wry smile.

He was a bit helpless too; this young man’s presentation really didn’t fit into any clear category.