The Enhanced Doctor

Chapter 1234: Chapter 1234: Diagnosing by Exclusion

We’ve just seen a few patients, mostly with colds and enteritis.

Actually, it’s also the time for gatherings, when overeating and excessive drinking happen, so there are indeed quite a few cases of acute enteritis.

Please, take care of your diet. It’s really necessary.

Some people are so eager to satisfy a year’s worth of cravings during the New Year, eating non-stop. This is terrible because it far exceeds the digestive capacity of your gastrointestinal tract.

Then there are those who just keep drinking, which can also lead to problems. The body can’t process so much alcohol, which easily invites other ailments.

"Doctor, doctor, I’m really anemic."

Just after seeing a patient, the dizzy young man came running over, looking much paler.

"Let me see. Wow, your hemoglobin is indeed a bit low, only 83."

After taking a look at the report, Liu Banxia said.

"There’s nothing else wrong, but such low hemoglobin levels confirm anemia. The general causes of anemia are quite limited; it either means there’s an issue with your body’s blood production or there are bleeding points in your body," Liu Banxia said.

"There’s also the possibility of excessive dieting, recent heavy drinking, or other conditions that might contribute. Think it over and see if any of these might be related to you."

"Uh... could it be caused by bleeding from hemorrhoids?" the patient thought for a moment and asked.

"Based on your description, that’s quite unlikely," Liu Banxia said.

"If hemorrhoidal bleeding caused anemia, there would be a lot of blood in the toilet when you defecate, not just on the toilet paper."

"Doctor, could it be an incurable illness?" the patient asked worriedly.

"Don’t overthink it, we can eliminate possibilities one by one. Did you send your stool for testing?" Liu Banxia asked.

"I did, but I think the results won’t be out soon," the patient said.

"Doctor, isn’t there another way to quickly check for the cause of my anemia? I’m really feeling dizzy now, and I’m sweating."

"You’re just scared," Liu Banxia said.

"I’ve told you not to overthink. We can rule things out gradually. To pinpoint the cause instantly would require a lot of expensive tests."

"In my judgment, the likelihood of gastrointestinal bleeding is quite high, especially in the upper gastrointestinal tract. When there’s upper gastrointestinal bleeding, the stool is often darker in color."

"Since there are no other symptoms, this possibility is still quite high. Now, it’s up to you to decide whether to wait for the stool test results and continue testing or to directly proceed with an endoscopy to check the upper gastrointestinal tract."

"Doctor, I’m afraid I can’t handle the endoscopy. Is there any other way?" the patient said with a grim expression.

Liu Banxia shook his head, "Although there are only a few causes of anemia, our entire diagnostic process involves gradual elimination."

"Think of it this way. Unless there’s a sign pointing clearly to a disease, our diagnostic method is process-of-elimination, verifying step by step from lower complexity to higher."

"You were actually asking earlier if faster methods exist to rule out diseases causing this anemia. Were you concerned about cancer?"

The young man nodded slightly.

"Such tests exist too, but they cost thousands. Doesn’t seem very worthwhile, does it?" Liu Banxia said.

"Thus, let’s take a straightforward approach—eliminate possibilities gradually. Doing an endoscopy is the best way to observe the upper gastrointestinal tract."

"If you’re worried about discomfort in your throat, you can undergo a painless gastroscopy. You’ll be anesthetized, and when you wake up, it’ll all be over."

"The downside is the cost is relatively high, as it includes anesthesia fees—about two thousand yuan. It’s akin to undergoing a small operation, albeit less invasive."

"If you opt for painless gastroscopy, it’s best to have a relative accompany you, as you’ll need some recovery time post-anesthesia."

The patient appeared hesitant, wanting to undergo the procedure immediately to ease his mind, but was afraid of not having anyone there if something happened afterward.

"Then I’ll wait a bit, call someone over," the patient decided after some thought.

"Okay, I’ll issue the test request. If your family arrives quickly, it’ll be just in time."

"Doctor, you suspect upper gastrointestinal tract bleeding, right?" the patient pressed further.

"We’ll know for sure after the endoscopy. If there are bleeding points, they will be clearly visible," Liu Banxia said.

The patient nodded and went to pay the fee.

Liu Banxia stretched a little; after dealing with so many cases, the pressure had lessened.

"Did Liu Yiqing’s patient family member leave?"

Seeing Liu Yiqing, Liu Banxia inquired.

"Yeah, she signed and then left." Liu Yiqing said.

"Their family’s situation is really hard to assess." Liu Banxia said.

"Did she leave any contact details before leaving? Or the patient’s parents’ contacts? In case anything goes wrong during the surgery, it would be good to have a way to reach them."

"She left some, but asked not to contact her unless necessary. She also left her father’s phone number, but it’s not from Binhai City. I’ve called twice, but no one answered." Liu Yiqing said.

"We’ll see how it goes. Although the surgery carries risks, with Director Xiao operating, it should be quite safe." Liu Banxia said.

He really doesn’t think highly of this patient. If you’re looking outside, you should just get divorced early. Likely, it’s all tangled with property division, which is why things got so messy.

At least the woman he found has a decent heart, otherwise, the only thing he could offer is a sad farewell.

"Note down that patient. I’ll arrange for him to have a painless gastroscopy. If he doesn’t have family by the afternoon, coordinate after the results come out." Liu Banxia continued.

"If it’s negative, get a consultation with internal medicine. His main symptom is dizziness, and his blood test shows hemoglobin at 83, I suspect it’s upper gastrointestinal bleeding."

"Got it, I’ve noted it." Liu Yiqing nodded.

Liu Banxia returned to his office upstairs, pulling up Liu Yiqing’s sister-in-law’s records to review them again for thoroughness.

"Director Liu, are you busy? I wanted to talk to you about something."

Just as he was reviewing the files, Liu Yiqing’s elder brother knocked and entered the office.

"I’m not busy right now." Liu Banxia said.

"Director Liu, could you reduce the surgery fees a bit more? We’re still short on money." Liu Yiqing’s elder brother said.

"I’ve waived everything possible, and that was through Liu Yiqing’s application." Liu Banxia said.

He couldn’t fathom how selfish this person really was, or perhaps it’s just his nature to want to gain advantage.

"The main issue is the unexpectedly high cost of post-operation chemotherapy. If we undergo chemotherapy here, is there any discount?" Liu Yiqing’s elder brother continued to ask.

"Chemotherapy costs have corresponding reimbursement ratios, but it mainly depends on whether the drugs are on the insurance list. In this aspect, I can’t do anything further, it’s beyond my authority."

"Director Liu, I heard from other patients in the ward that at the beginning of such surgeries there were discounts?" Liu Yiqing’s elder brother hesitated slightly but asked anyway.

"That was during the initial phase when recruiting patients for this surgery. Now the procedure has matured, so the hospital canceled those discounts." Liu Banxia explained as patiently as possible.

"To be honest with you, we’ve provided all possible discounts. Any further reduction would have to come out of my own pocket as the chief surgeon."

"You might want to reconsider whether to proceed with this surgery or to just go for the rectal excavation as well. Before 1 PM today, you have the freedom to make that choice."

"I... we’ll think about it, thank you, Director Liu."

After saying that, he left the room.

After some thought, Liu Banxia sent Liu Yiqing a message.

He’s unsure whether their family is genuinely broke or just trying to score more advantages, but he leans toward the latter. So he needed to warn Liu Yiqing not to be fooled again.

This girl tends to be soft-hearted.

His judgment was based on the fact that yesterday they didn’t even prioritize treatment fees. But now, with some discounts given, their attitude changed.

He hasn’t encountered such bizarre people for quite a while, it’s really irritating him.

Still feeling uneasy, he asked Xu Yino, who was down on the ground floor today, to keep an eye on them.

Within less than five minutes, Xu Yino texted him that they indeed went to find Liu Yiqing.

He didn’t even know how to critique it anymore. Liu Yiqing really has been more than generous, yet they still don’t know when enough is enough.

If it were his previous temper, he might have sent them elsewhere by now. Whoever can operate should handle it, we refuse to serve you, is that okay?

But it’s not feasible; he is currently the deputy director of the Emergency Center and also in charge of Department Two. Although Liu Yiqing’s elder brother is quite annoying, his wife must still receive treatment.

Because this matter pertains to Liu Yiqing’s family, just like the other patient’s family issues, his emotions can’t interfere during the treatment process.

He has also alerted Liu Yiqing. It’s up to her whether she can persist.

At least he feels that he has grown, at least when considering things, he won’t be as impulsive as before.

Maybe now he finally qualifies as a competent doctor. Despite the overly impressive title granted by the system, he knows his actual situation well.

Especially during recent patient consultations, he considers more aspects. When scheduling equipment checks, he tries to ensure "symptom-specific examinations."

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