The Enhanced Doctor

Chapter 1194: Chapter 1194: Consultation at the Dining Table

(Thanks to DRDER, Lu Hongzhang, Fat Monkey King, Anlin Xiaoxiao for encouraging with the monthly ticket)

They arrived at the cafeteria, and Zhou Qiang directly started setting the food on the table as soon as he saw them coming.

At this time, it was indeed past mealtime, but it was peaceful now without many people around.

"Manager Zhou, you’re impressive. Did you arrange a little spy or something? Perfect timing," Liu Banxia joked.

"I don’t have such skills. Xu Yino made the call, guessing you’d arrive around this time," Zhou Qiang replied.

"I was wondering, how did you time it so well? But these standards are a bit high; my meal card is hurting a little," Liu Banxia said.

"Haha, Xu Yino picked the dishes. She said you would definitely complain, but we can’t help it. We’re happy today; we have to eat something nice," Zhou Qiang said with a smile.

Everyone laughed; these dishes were all individually cooked, naturally more expensive than standard meals.

But it didn’t matter. As Zhou Qiang just said, today was indeed a happy day.

"Let’s explore while eating. Everyone can share their thoughts since you’ve all seen the patient’s skin condition. Express your opinions," Zhou Shuwen suggested.

"Director, I think we can consider starting with skin relaxation syndrome. Although it’s not very evident yet, it should be a direction," Su Wenhao said.

"If we judge by his current occupation, could it be acquired?" Miao Rui chimed in.

"If it’s congenital, it would definitely show in infancy. An important sign of this disease is emphysema, right?"

"Very good," Zhou Shuwen nodded.

"I’ve heard you often hold similar consultations, and this method is great. It allows everyone to progress through discussion, gaining more than just textbook knowledge."

"Does anyone want to add anything? Eating is just idle time, so it’s better to discuss the patient’s condition. Your small chopstick usage seems quite adept now; when will you switch to even smaller ones?"

Zhou Shuwen’s last question made everyone’s face turn bitter.

Why does the director love to torture us too? Our small chopstick skills aren’t that great yet; compared to Teacher Liu, we’re way behind. Don’t switch to smaller ones so soon.

"You all need continuous practice," Liu Banxia said gleefully.

"Got tricked, didn’t you? Is switching chopsticks the important part here? The key is whether this patient’s current situation involves a real condition."

"Look at you, so clueless, like Liu Yiqing. That girl practically takes everything at face value. Mention a problem, and she’ll focus solely on that without considering anything else."

Upon hearing him, everyone suddenly realized.

Indeed, Director Zhou led them astray.

If Liu Banxia had set the trap, this group might have been alert. But it was the esteemed Director Zhou, the deputy chief director, setting it, so everyone let their guard down significantly.

"I must say, it’s quite fun," Zhou Shuwen chuckled.

Everyone felt speechless, still not entirely adapting to this version of Zhou Shuwen.

"Li Hao, you should share too. Su Wenhao and Miao Rui have shared their thoughts," Liu Banxia said.

Time to change the topic; he wasn’t sure if his dear teacher had been misled.

"If considering acquired skin relaxation syndrome, its clinical manifestations resemble congenital ones. Both have symptoms like skin relaxation, emphysema, multiple diverticula, and cardiovascular changes," Li Hao stated.

"However, the main difference between acquired and congenital lies in age, primarily appearing in youth or adulthood. Considering this patient’s situation, could it be early onset, showing only skin symptoms?"

"Thus, I think we should inquire with the patient’s family. If it’s acquired skin relaxation syndrome, there might be other skin disease histories we can corroborate indirectly."

Zhou Shuwen nodded, "Judging from your responses, I find your considerations quite comprehensive. Your knowledge grasp is quite broad too."

"Although skin relaxation syndrome isn’t a popular condition, many patients directly seek plastic surgery. For us, regardless of the cause, it’s not something we can change."

"But remember, don’t be confined to the first impression. We’re limited to discussing skin relaxation syndrome now, but what about the world outside? Could it be more interesting?"

Upon hearing Zhou Shuwen, everyone glanced at Liu Banxia, who was busily eating.

The hint was clear: this patient might not have skin relaxation syndrome.

Their initial impression limited by knowledge was this disease.

"Why are you all looking at me? Follow the director’s lead," Liu Banxia said.

"Teacher Liu, have some braised pork slices and say a few words," Miao Rui said.

"Actually, what the director means is that when we see patients, unless there’s a positive indication from some diagnostic tool that can directly diagnose, we should think more broadly," Liu Banxia said.

"Currently, the patient’s skin condition leans towards cutis laxa syndrome, but this disease also has similar symptomatic diseases."

"For example, conditions like skin hyperelasticity, pseudoxanthoma elasticum, and multiple neurofibromas. However, the symptoms of the latter two are quite evident and easy to distinguish."

"Pseudoxanthoma elasticum is most evident at the folds on both sides of the neck, characterized by typical distinctive yellow rashes. Multiple neurofibromas manifest as soft, localized bumps, and another is the presence of café-au-lait spots."

"These are all covered in books, but for this patient, the focus is distinguishing between cutis laxa syndrome and skin hyperelasticity."

"We’ve only observed the patient’s skin manifestations, so to truly differentiate, we need to conduct further examinations on the patient. Right?"

Seeing Liu Banxia’s smiling expression, everyone instinctively felt it was a trap, one they shouldn’t fall into.

"Teacher Liu, couldn’t we verify with the patient’s family or those around them to help differentiate?" Cui Jia tentatively asked.

"It seems you haven’t detailed the case for skin hyperelasticity syndrome, so there must be other external manifestations."

Her words echoed the sentiments of everyone, who nodded in agreement.

"Why are you all so cheeky? Can’t you just nod obediently?" Liu Banxia said helplessly.

"Another significant symptom is a wide range of joint movements. However, this prominent symptom is often overlooked and instead viewed as the trait of a ’peculiar person.’

"After the meal, we can consult the patient’s family and friends further, which should essentially allow us to determine it. By distinguishing this point, we can ascertain which disease it is."

"Of course, it could also be due to some connective tissue change caused by a disease we aren’t familiar with. But this can be discussed after excluding obvious symptoms."

Everyone nodded happily.

They knew Teacher Liu would lay traps. The two similar cases were explained clearly, but this last one was glossed over, which surely raised questions.

Zhou Shuwen nodded in satisfaction. Even though it seemed like a playful consultation over a meal, the effect was excellent.

Liu Banxia left the last obvious trap, hoping this situation would make the children’s memory of it deeper.

People tend to remember interesting things longer. Simple case study learning can be dull and tiresome.

Now, Liu Banxia has discovered a teaching method suitable for himself, and it’s really quite good.

It has a certain entertainment value while keeping these children alert. Whether it’s obvious or hidden traps, these traps are all knowledge points.

However, this method is currently only suitable for Liu Banxia to use. If someone else tried this, they would likely feel quite pressured.

To be exact, no one else has his lively personality and abundant energy.

Conducting surgery is tiring as it is. At mealtime, you’d rather eat quickly and rest; there’s no time to chat about these things.

"What time are you leaving tomorrow afternoon?" Zhou Shuwen asked.

"Around two o’clock," Liu Banxia said.

"When we get there, we’ll try not to take up their work time while adjusting the equipment, and later just ask them to properly disinfect it, and it will be done."

"Great, in the future, we should strengthen our ties with local hospitals. This way, we can have more contacts in some units. Even if it’s just for a short period, it can alleviate a lot of personnel pressure for us."

"Have you all currently mastered laparoscopic appendectomy procedures? Is it a problem if you later practice in other hospitals?"

"Director, while we can meet the standards, compared to Teacher Liu’s, we’re still a bit lacking," Miao Rui said.

"That means there aren’t significant issues. Back then, your Teacher Liu made his name with that one skill," Zhou Shuwen said with a smile.

"While enhancing our medical standards, we also need to increase our influence within the whole system. Especially since you each have your own departments now, you can’t solely focus on NOSES surgery patients."

"That’s just one project of our emergency center. The patients we need to focus on are still trauma emergency patients, like today’s case."

"Another focus is self-initiated consultations. This is what we need to pay attention to. Hospitals need to make money; otherwise, how can we afford equipment or hire more people?"

Liu Banxia nodded, "Regarding influence, we will think of a way."

Indeed, this aspect needs more attention in the future.

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