Practicing Medical Skills in a Small Clinic

Chapter 753: Chapter 350: Seniority Rules, Please Return

What’s going on with Director Jin today?

Usually, despite his seemingly amiable smile, he never easily yields to any doctor’s opinion. When invited for a consultation, he either dodges the issue or is very assertive.

To unconditionally support a young doctor’s diagnosis like today is truly a first.

"Director Jin, checking the EEG and brain CT will waste quite a bit of time. The child’s condition has clearly improved after receiving cardiotonic treatment, indicating that it’s a heart issue. Shouldn’t we focus on the heart first, and only check the brain once the child’s condition stabilizes?"

Director Yan of the emergency department even feels that checking the brain is unnecessary.

It’s obviously a heart condition!

The low heart rate resulted in insufficient blood supply to the head, causing the coma, and that’s an indisputable fact.

"I think checking the heart can actually wait. It’s best to do an EEG right away, and test the cerebrospinal fluid, and if possible, first check serum antibodies. Have any of you considered that the child’s low heart rate may not be a recurrence of heart disease, but possibly a result of a brain problem causing the heart rate to slow down? In the surgical cases I’ve encountered, there’s a phenomenon where nerve problems lead to inadequate blood supply to the limbs, making the patient feel one side of their lower limb is cold. There’s also muscle atrophy on that side."

Li Jingsheng boldly expressed his viewpoint.

Nervous system issues can cause muscle atrophy and poor blood supply, which is practical clinical knowledge.

Experienced surgeons know this best.

Li Jingsheng has performed many surgeries over the past few months, accumulating more and more practical experience.

This is already showing results in this child’s diagnosis.

This is the result of improved overall skill.

"Although the child’s condition appears to have improved, if we don’t quickly investigate the brain cause, I believe the child’s condition could rapidly deteriorate. Therefore, I suggest immediately checking for brain inflammation, viral infection, or other such issues."

Li Jingsheng’s almost obsessive diagnostic style made Director Yan and Director Luo feel this young man is still too inexperienced.

Because Li Jingsheng initially determined that the child might have a viral infection.

Now, after the consultation, they all believe it’s more likely the child has a recurrence of rheumatic heart disease and subdural hematoma.

Not a viral infection.

"Xiaoli, we can’t rely solely on experience to make assumptions when diagnosing patients. You’re young, your clinical experience is actually quite limited, and being stubborn about your initial thoughts without considering evidence can easily lead to dead ends. I’ve been working in the emergency department for almost thirty years, yet I wouldn’t dare say my experience is that rich. Right now, I think it’s most important to first check the heart.

I don’t deny there may be a problem with the child’s brain.

But what was the result after the child received cardiotonic treatment? The child immediately regained consciousness from the coma. All signs showed improvement, and that’s undeniable."

Director Yan even changed the way he addressed him.

From Dr. Li to Xiaoli.

Clearly, Li Jingsheng’s way of stating his viewpoint based on personal experience made Director Yan somewhat displeased.

A young doctor showing off in front of these fifty- and sixty-year-old director doctors?

It’s simply absurd and arrogant.

"I support Director Yan’s opinion. Words may be rough, but the truth is clear—you cannot diagnose based on subjective assumptions, you must rely on factual evidence. First check the heart problem, find ways to stabilize the heart rate, even restore it to normal levels, that’s the key to solving the issue."

Director Luo of the neurology department sided with Director Yan.

Knocked Li Jingsheng down a couple of notches, advising him against being too stubborn in diagnoses; otherwise, he’d be irresponsible.

"Secretary Bei, you’ve overheard our discussion just now, do you think it’s okay for us to first check the child’s heart problem?"

Director Luo asked, somewhat looking to gain favor.

Among the directors, Director Luo is the most cunning.

He avoids blame when there’s risk.

But doesn’t hesitate when there’s credit to be garnered.

He only dared to step forward after seeing the child’s condition improve following the first round of treatment.

Secretary Bei nodded, "You’re all experts in emergency and neurology, with richer experience and more authority. I trust you, it’s good to first check the heart problem. When my son was four years old, he developed rheumatic heart disease, and during hospitalization fell into a coma once, very similar to this time."

"All right, we’ll soon submit inspection orders and expedite them through the green channel for testing."

Director Luo was very pleased to get the family’s approval.

Not forgetting to flatter all around.

"Here in orthopedics, we can’t offer much help for now, so we’ll be going. If needed, feel free to call me at any time. The child’s right arm is fractured, once the condition stabilizes, it can be transferred to us in orthopedics for treatment."

Director Hua stood up, preparing to leave with Li Jingsheng.

Director Yan and Director Luo’s criticism of Li Jingsheng clearly made him unhappy. However, their comments seemed to hold some validity, and he couldn’t refute them.

Plus, with the family present, it’s easy to be laughed at.

"All right, thank you, Director Hua!"

Director Yan stood up to see them off.

"Thank you!"

Secretary Bei also shook hands with Director Hua.

Then shook hands with Li Jingsheng, "Thank you, Dr. Li, for actively participating in my son’s rescue. Even though your advice wasn’t ultimately adopted, I am still very grateful."

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