(Thanks to sincostgctg and Wang Lintai for the encouragement with the monthly ticket)

"Teacher Liu, a preliminary physical examination shows the patient’s vital signs are stable, blood pressure and heart rate are slightly high, body temperature is normal. The abdomen is soft, but there is tenderness on palpation, bowel sounds are normal. Both McBurney’s point and Murphy’s sign are negative, no back pain."

After waiting for a while, Xu Yino pulled back the curtain and came out.

Liu Banxia nodded, matching his preliminary judgment, the patient’s condition was indeed complex.

Although McBurney’s point and Murphy’s sign are not truly gold standards and can have deviations, they generally help rule out appendicitis and cholecystitis.

The slightly high blood pressure and heart rate are likely triggered by the patient’s abdominal pain.

"Let me check again." Liu Banxia thought for a moment and said.

Xu Yino didn’t mind, as her fingers weren’t as precise in sensation as Liu Banxia’s.

"Dr. Liu, what examination do we do next?" the patient asked upon seeing Liu Banxia.

"I’ll check again, and then we need to get on the instruments." Liu Banxia said.

"Any examination is fine, as long as it can cure my illness," the patient said.

This wasn’t her first time saying this, proving that the pain really tormented her.

Liu Banxia gently pressed on her abdomen a few times but could not give an accurate judgment. Whether due to the patient’s strong stress response or otherwise, everywhere he pressed was painful.

"Does it always hurt, or only in certain situations? How about when eating?" Liu Banxia asked.

"It always hurts; I can barely eat. The pain makes it impossible to do anything. I’ve been on sick leave for a long time now, can’t work at all." the patient said.

"Bear with it for now, let’s give you some pain relief medication. Complete blood count, blood chemistry, urinalysis, then a CT scan of the abdomen and pelvis." Liu Banxia said. 𝗳𝚛𝗲𝕖𝚠𝚎𝚋𝗻𝗼𝕧𝗲𝐥.𝚌𝚘𝐦

"Are we not doing transvaginal ultrasound? They also said I might have endometriosis or an ectopic pregnancy, but two exams failed to show anything," the patient asked.

"Okay, let’s do one too." Liu Banxia said.

"Currently, these are non-invasive examinations. Once these are complete, let’s also get an ECG. Sometimes heart conditions can also cause abdominal pain."

"Alright, let’s do it. Nobody focused on this. Even if it’s heart disease, I’ll accept it." the patient said.

For patients who trust him unconditionally, Liu Banxia actually feels a lot of pressure. He worries that these instrument checks will all be negative, showing nothing.

This wouldn’t be living up to the patient’s trust, even though he didn’t ask the patient to rank the pain level. It has already affected her normal work and life, indicating it’s not low pain.

The patient isn’t very old; her information shows she’s just 28 years old.

If really no diagnosis can be made, and the patient continues to suffer, it’s feared that within one or two years, her life might be wasted.

The reason he asked about whether the pain worsens when eating was to see if it might be mesenteric ischemia syndrome or arcuate ligament compression syndrome.

He has diagnosed such patients before, and the pain was truly severe.

However, from the patient’s description, those can be largely ruled out. If still undiagnosed, enhanced CT could be considered, but cautiously.

Liu Banxia takes this patient seriously, and without needing much instruction, Xu Yino follows the case closely.

Understanding the complexity of this patient’s condition, she doesn’t want to miss anything.

Once this patient goes for examination, Liu Banxia looks around and then heads to the VIP ward with Zhang Xiao.

"Your meningioma seems quite large, but the surgery isn’t very complex. Tomorrow morning, we’ll do pre-operative checks, and perform the surgery in the afternoon." Zhang Xiao said.

"Additionally, these brain tumors are generally benign, and once removed, they won’t affect you further. Soon, I’ll arrange someone to explain the entire surgical process to you. If you don’t understand or have reservations, feel free to ask questions."

"Doctor, you don’t need to explain it to me." the patient said.

"That won’t do. It’s a required procedure. Moreover, even if Director Liu isn’t here, we would still explain it to you." Zhang Xiao said.

"Then, for now, take a good rest today. Your mental state is also important. It’s not a major surgery. If anything arises, let the nurse call me."

The patient nodded, and only then did Liu Banxia leave the ward with Zhang Xiao.

"Is she the legendary patient?" Zhang Xiao asked as they walked outside.

"Yes, quite skilled at fortune-telling. It’s rather miraculous; I find it impressive." Liu Banxia said.

"I was about to say the tumor only caused hallucinations and auditory illusions, and it would be fine once removed. Remembering what Liu Yiqing told me, I dared not mention it." Zhang Xiao said.

"Actually, it’s nothing much; in this regard, he’s stronger than anyone would imagine," Liu Banxia said.

"Didn’t you see how calm he was? I think he’s similar to people often described as ’heart like dead ashes.’ Someone who’s not afraid of death really has little that can provoke him."

"I hesitated when persuading him, even though our surgery can relieve his physical symptoms, his mental symptoms can’t be cured."

"He cares deeply for his girlfriend. Just because I mentioned her name, he treats me much better than he does you all."

"So, after the surgery, he won’t be able to see his girlfriend anymore. This emptiness and torment, I don’t know how he’s going to endure it."

"Didn’t you persuade him to see a psychologist?" Zhang Xiao asked.

"I wanted to, but I didn’t dare say it," Liu Banxia said with a bitter smile.

"Seeing the hallucination of his girlfriend is his psychological support. He’s not like other schizophrenia patients who believe their hallucinations are real."

"In his case, he knows it’s fake, just deliberately treats it as real, wanting through this way to be with his deceased girlfriend."

"Otherwise, it wouldn’t be so complicated. Communicating with him now seems fine to me. After surgery, especially when you’re doing related tests, pay extra attention then."

"I feel he’ll be very vulnerable then, without family to rely on, he can only depend on us. That’s why I asked Liu Yiqing to help, figuring we can pay more attention to his feelings."

"Oh... Why is it so difficult to be a doctor now, we have to consider everything?" Zhang Xiao sighed.

"For your emergency knowledge go-to-campus activity, do you need to pull someone from our neurosurgery department? If you do, it’d be best to pull as few as possible."

"Just pull one, mostly our general surgery department taking the lead, with other departments assisting," Liu Banxia said.

"I don’t dare pull anyone from pediatrics or orthopedics either, but doing this is at least meaningful, so it must be accomplished."

"Haha, then I’ll leave it up to you; after all, we just need to contribute one. I’m heading off now; I need to go back and discuss the surgery with the interns," Zhang Xiao said.

"I’ll go down with you, also need to check out orthopedics. Even if I’m not pulling anyone from them, I want them to know I’m good, and check on a patient transferred to them."

"Surely a young patient," Zhang Xiao said.

"How did you know?" Liu Banxia was curious.

"Don’t I know your habits? You rarely inquire about follow-ups for unfamiliar people; Xu Yino usually handles them."

"It’s probably a bad habit they instilled in me from the start; I seldom do rounds myself, only check on key patients, the rest are handed to them," Liu Banxia said.

Everyone has their habits; his little habit is slightly arrogant but is tolerated at the emergency center.

His patients are managed by ’the little six,’ making it fairly easy. Other new medical graduates might find the difficulty high, but not these ones.

"Oh, Doctor Wu, doing rounds?" Just out of the elevator, Liu Banxia saw Wu Mingyu coming out of a ward and greeted him.

"Yes, lately we have more orthopedic patients, keeping me busy nonstop. What brings you here?" Wu Mingyu asked.

"Checking on the tethered cord syndrome patient, seeing how the recovery is going," Liu Banxia asked.

Wu Mingyu gave him a helpless look, "The surgery was only done yesterday, not something I can handle alone; Teacher Wang just had time yesterday, forced his way in."

"No worries, knowing surgery was done yesterday is why I’m here today," Liu Banxia said.

"To ensure orthopedics can proceed with admissions orderly, we’re not including you in this campus activity. How’s that? Fair enough? Tomorrow, do I get something extra for lunch?"

"Haha, pulling people is fine; you’ll come to cover anyway," Wu Mingyu said indifferently.

Liu Banxia felt helpless, knowing his firefighter role was constant.

Upon reaching the ward, Liu Banxia directly approached the young man. Though still a student, he was indeed a young man.

"Congratulations, the surgery was successful. From now on, you won’t be bothered by this illness, and can grow happily and healthily," Liu Banxia said.

"Director Liu, thanks to you, otherwise the child’s diagnosis would’ve been delayed," the patient’s mother said.

"It’s nothing, the key credit goes to the orthopedic doctors. I can only guess, the actual hands-on work was all theirs," Liu Banxia said.

"Follow the doctor’s advice, and recover well; that’s most important. Seeing him I feel assured, his condition is good. Maintain this, a good mood speeds recovery."

"I saw you in the corridor, not busy these days? Director Xu is still waiting to see when you’ll join him on stage."

Just as he finished speaking, Wang Bo’s voice from orthopedics came from behind.