The knocking on the door sounded pleasant to the ears.
It was almost time to get off work, so the chances that this was a follow-up patient was very slim.
Generally, follow-up patients would come in early in the morning or at the beginning of the afternoon.
Zhou Can readied himself to earn some Experience Points.
Dr. Hee's voice was always so gentle and rich.
The door to the clinic opened, and a man in his forties entered with the help of his family. He was holding his abdomen with one hand, a pained expression on his face.
"Ouch, ouch... Doctor, my stomach hurts so badly, please take a look at me!"
The man's pain was evident from his pale face and the cold sweat on his forehead.
Dr. Hee remained very calm and composed.
"When did the pain start?"
"It's been two days now, I've been in pain for two days, oh..."
The man kept groaning in pain.
The pain must be intense to affect a middle-aged man this way.
"Have you consumed anything toxic recently? Like poisonous mushrooms, toads, or fruits and vegetables sprayed with pesticides?"
"No, definitely not. I've been eating at home these past few days, and my wife and children are all fine."
"Do you smoke or drink?"
"Do family members have a similar medical history?"
"Come, help him lie flat on the bed, I'll do a physical examination."
Dr. Hee instructed the family members to help the patient onto the bed to lie flat and then began the examination.
Xiao Zhou also got up and followed to watch.
Based on the patient's description and the symptoms he was exhibiting, Xiao Zhou had already begun making pathological deductions.
However, without examination data and sufficient clinical diagnostic experience, it was difficult to determine the pathological mechanism of the patient's condition.
There are just too many possible causes of abdominal pain.
Peritonitis, gastroenteritis, cholelithiasis, appendicitis, and many other diseases can cause severe abdominal pain.
Dr. Hee pressed his hands on the patient's abdomen.
"Ouch... gently, gently..."
The patient immediately cried out in pain.
"So, it's only this area that hurts, right?"
"The right shoulder and the right back also hurt, but not as badly as my stomach."
Xiao Zhou understood immediately that this was radiating pain caused by severe upper abdominal pain.
It's like throwing a stone into a pond; ripples spread out from the center where the stone landed.
Pain works in a similar way.
It's transmitted through nerves to surrounding areas.
This phenomenon is medically termed as radiating pain.
Now it was almost certain that the initial site of pain was in the upper right abdomen area.
"Did your abdominal pain appear suddenly two days ago, or did it come on gradually?"
"Suddenly. There were no signs; it just started hurting out of nowhere, intermittently. And with each bout of pain, it intensified. Eventually, it became unbearable, and I even vomited a few times."
The patient provided another clue.
This is why inquiry is so important.
One cannot be afraid of the trouble, and must ask for more related information.
"Seeing as the pain was so severe, you couldn't have possibly waited until now to seek medical attention, right? Have you visited any other hospitals?"
Dr. Hee, with his rich medical experience, immediately deduced some truths the patient had not disclosed, according to the symptoms described.
"Uh... I did go to a small clinic before. They gave me an IV, said it was anti-inflammatory. It didn't help, and the clinic owner, afraid of trouble, advised me to go to a larger hospital."
Those small clinics, they readily prescribe IV drips to patients.
Overuse of various antibiotics is most egregious in these small clinics.
Some minor colds or symptoms, treated with intravenous antibiotics, do indeed recover quickly.
Little do they know, it's akin to quenching thirst by drinking poison.
This time, the recovery is fast, but the body's immune system gets disrupted and weakened, leading to a higher chance of falling ill again. The subsequent illnesses become more severe.
Such repetition leads to a vicious cycle.
By the time patients truly require antibiotics for treatment, sadly, they often find that no medication is effective.
This is because the viruses in their bodies have developed significant drug resistance.
Even a common cold might result in a super virus.
"Now, other than abdominal pain, you have pain in your right shoulder and back, any other symptoms? Your abdomen feels quite hot to the touch!"
Physical examination is a doctor's preliminary check after seeing a patient.
This is extremely important.
It can help doctors detect some hidden conditions of the patient.
Some patients might be embarrassed or consider their symptoms trivial and deliberately conceal them. This is when doctors need to have keen eyesight.
"I'm feeling feverish and have chills."
"Mm, let's take your temperature and measure your heart rate and blood pressure first. Relax, don't be nervous. Here with us, we will certainly do our utmost to treat you."
After Dr. Hee comforted the patient, Zhou Can quickly took the initiative to measure the patient's blood pressure, heart rate, and temperature without waiting for instructions.
These basic tasks couldn't possibly trouble a senior doctor.
Being proactive would certainly leave a good impression on Dr. Hee.
The likelihood of being asked to sit in on consultations again would significantly increase.
"Temperature 39.6, pulse 98 per minute, blood pressure 120 mmHg. No abnormalities were found during lung percussion, no noise heard during breathing, about 25 breaths per minute."
Zhou Can conducted a series of measurements on the patient.
A temperature range of 39.1 to 41 degrees is considered high fever.
This patient's condition is more serious and complicated than expected.
"Let's get a complete blood count and an ultrasound first. If the results are not ideal, we might need to proceed with a CT scan," Dr. Hee said, addressing both the patient and Zhou Can.
Zhou Can hurriedly went to the computer to make a request for medical tests.
"Your condition is complicated, and the outpatient department is closing soon. We can't admit you to the hospital without a clear diagnosis from your test results. After your tests, I suggest you go to General Surgery at the inpatient department and look for Dr. Fang. I'll make sure to inform him about your situation."
The patient's condition could deteriorate at any moment.
Dr. Hee did not take it lightly.
If the condition were not serious, patients would usually be asked to return the next day.
After the patient left, Dr. Hee stood up, ready to leave for the day.
"Xiao Zhou, how was it? Did you learn anything after spending the afternoon in consultations with me?"
"I've learned a lot. The process and methods of seeing various patients have been very beneficial to me, especially in terms of medical ethics and professionalism; you've set an excellent example for me."
"Ha, you flatter me. Alright, the nurses from the information desk will come to close up. Let's go."
After leaving the consultation room with Dr. Hee, Zhou Can was still pondering what disease the last patient might have contracted.
He was only 1.4 Experience Points away— he couldn't give up just yet!
Severe pain in the upper right abdomen radiating to the right shoulder and back, the patient's habits of smoking and drinking alcohol, coupled with high fever and chills—when all these symptoms were combined, it pointed towards an issue with the bile duct.
Could it be a common bile duct stone?
Zhou Can felt like he had grasped something, his eyes shining like stars.
Every time a doctor diagnoses a patient, it's like solving a math word problem.
After finding the right solution, there's a special sense of accomplishment.
[Pathological Diagnosis Experience Points +0.4.]
The long-awaited Experience Points appeared again.
Just that it was a bit minimal!
Only increased by 0.4.
Normally for clinical diagnosis, getting the correct answer would result in an increase of 1 Experience Point.
Why is it less than half this time?