This doctor is already middle-aged, and he's only just started practicing medicine.

Chapter 226 Day shift is busier than night shift!

Lu Cheng had just finished his night shift, but hadn't left work yet.

According to the usual shift schedule, the same person will be on the day shift in the ward after the night shift, which means that they will be transferred from the emergency room to the observation ward.

January 3rd was a shift change, not a Monday. Director Xiao Zhaoxi finished his shift and went home, so Tian Zhiliang from the second-line consultation team led the ward rounds.

Yesterday's ward night shift was Chen Fang's. After Lu Cheng handed over the shift to Chen Fang, Chen Fang could finally rest after making her rounds and was on standby.

Lu Cheng followed behind Tian Zhiliang, while Chen Fang was responsible for introducing the patients' conditions. During the ward rounds, she also handed over the duties to Lu Cheng, the doctor taking over the day shift.

The patients in the surgical observation ward of Xiangzhou People's Hospital are even more diverse than those in the observation ward of Longxian People's Hospital, consisting entirely of patients with minor to medium-sized trauma.

There aren't many patients, only five in total, so the turnover is very fast; three of them will be discharged today.

After walking around the room, Tian Zhiliang said, "Xiao Lu, there's nothing special in the ward today. Remember to complete your medical records from today."

"The day shift writes the medical records, while the night shift in the ward only records special treatments. You should know this rule, right?"

Lu Cheng immediately nodded: "Okay, no problem, Director Tian."

What types of antibiotics and painkillers does our department typically use?

When Lu Cheng was at Longxian People's Hospital, he had the authority to dispense medications on his own, and he was the chief surgeon at that time.

But now that he's at Xiangzhou People's Hospital, Lu Cheng is well aware of the department's rules; this is another orthopedics department.

If your superiors instruct you to use certain medications, just follow their instructions; there's no need to act on your own.

Tian Zhiliang glanced at Lu Cheng with a keen eye and noticed that Lu Cheng's expression was natural and not sarcastic. He said, "For antibiotics, cefuroxime or cefazolin are fine. Follow the consultation's opinion if there is one."

"Painkillers, like celecoxib, are fine. For swelling reduction, Daflon or Hemostatic are both good options."

Lu Cheng silently wrote down the names of the drugs that Tian Zhiliang had mentioned in his notebook.

After seeing Lu Cheng's record, Tian Zhiliang said, "Little Lu, you can decide for yourself."

Lu Cheng quickly replied, "It's alright, Director Tian. We'll just use whichever drugs our hospital is procuring."

"Okay, then you go and write the doctor's orders first. After that, you'll change the dressings, write the medical records, and complete the discharge procedures. Be ready to handle the admission procedures at any time. That's the daily routine for the day shift in the ward." Seeing that Lu Cheng was conscientious in his work, Tian Zhiliang gave Lu Cheng some guidance and guidance.

What Tian Zhiliang described were the trivial things that Lu Cheng often did. Lu Cheng operated them quite smoothly, except for not being very used to the medical order and medical record system here.

Around 11 a.m., Lu Cheng finished dealing with all the miscellaneous tasks.

After successfully handing over the discharge medical records and disease diagnosis certificates to the three patients, and letting them go to the nurses' station to reconcile their accounts, the patients were able to settle their bills and be discharged.

Just as Lu Cheng finished ordering takeout, two more patients were transferred to the surgical clinic. Both had minor injuries, and the orthopedics department was reluctant to admit them to avoid wasting ward space. However, the patients did need to be hospitalized for observation, so the emergency observation ward was the best place for them.

The hospitalization procedures are relatively simple. They just take the patient to the hospitalization system and order some very basic inpatient examinations, such as chest X-ray, electrocardiogram, and blood tests for inflammatory markers.

Generally, those who need to be hospitalized require intravenous anti-inflammatory treatment. The emergency room doctor will also give advice on the types of antibiotics. Lu Cheng only needs to do a simple repetition!

Therefore, the on-call duties in the emergency surgery department are indeed relatively relaxed.

This contrasts sharply with the busyness of the internal medicine department.

In the afternoon, Lu Cheng was reading a book while on duty, which was perfectly legitimate. Even if a patient saw it and reported it, the report would be invalid.

The on-call physician in the internal medicine department was running around at breakneck speed, conducting physical examinations while taking patients to the doctor's office to inquire about their medical history and basic information.

Lu Cheng discovered that there were many patients with severe colds, non-pneumonia, and non-severe infections in the internal medicine observation ward of Jilin City, and quite a few patients with severe flu symptoms.

However, the internal medicine wards and the surgical wards are relatively separate.

While reading, Lu Cheng felt a sense of tranquility amidst the hustle and bustle, finding a kind of elegance.

After observing for two hours, Lu Cheng returned to his old profession and went to inspect the surgical ward.

The surgical ward has three beds per room, with a total of three rooms and nine beds.

Currently, there are only four patients, two men and two women, living in two separate wards.

Beds 1 and 6 are for returning patients, while beds 2 and 4 are for patients who were just admitted today.

The old patient had been hospitalized for several days, so Lu Cheng didn't question her in detail. Instead, he went straight to bed 2 and asked, "Hello, Auntie, are you feeling alright now? Does your wound hurt?"

The woman was out shopping when she was scratched by goods that fell from a vehicle while walking on the street. She has already had surgery and said calmly, "I'm fine now, except the wound is a little swollen."

"Swelling of wounds is normal. In fact, local swelling of wounds is a defense mechanism of our body."

"Auntie, you told me before that you used to have high blood pressure, right? What was your blood pressure just measured?" Lu Cheng asked in a kind tone.

"Thank goodness, it's 90 out of 134!" the aunt said. "I'm usually quite healthy. If I hadn't been hit by the object, I would rarely come to the hospital."

Lu Cheng laughed: "Does your aunt have a routine physical examination every year?"

"A physical exam? No, I know my own body. Unlike you guys, I don't have a company that arranges physical exams for me."

"I'm retired now, and I'm too lazy to do it. I'm really in good health." The aunt was afraid that Lu Cheng would accuse her of having some kind of illness.

"Oh, don't be nervous. I'm just asking about your condition as usual. As long as you're healthy, that's fine."

"Then please get some rest. If you feel unwell, you can come to see our on-duty doctor anytime." Seeing that the aunt didn't intend to continue the conversation, Lu Cheng immediately turned and left.

Bed 3 is vacant, and bed 4 is an unused bed next door.

The patient in bed 4 was a young man dressed in Blue Knight attire, who looked two or three years older than Lu Cheng.

He injured his leg and had to be hospitalized after debridement and suturing. He was also quite compliant with medical advice.

When Lu Cheng entered the ward, the man was lying on the bed reading a novel, his bandaged left leg dangling over the edge of the bed. Upon seeing Lu Cheng, he intended to stand up and greet him: "Brother, don't move. How are you feeling now? Does it hurt?"

"It's alright, it hurts a little, but I'm used to it." The young man's dark face showed a somewhat weathered smile.

The food delivery job is a long-term outdoor job, and the more you work, the more you earn. You are exposed to the sun and rain, so your skin is quite rough.

"Does it hurt a little? Did you take any medicine?" Lu Cheng's eyes flashed.

“I took it, but I didn’t take the painkillers you prescribed. I feel okay, I can bear it.”

"Doctor, can I return this medicine?" the young man asked.

Lu Cheng smiled: "You can cancel it if you want, but I still suggest you take some. In addition to pain relief, this nonsteroidal anti-inflammatory drug has more anti-inflammatory effects."

"Antibiotics are antibacterial, but antibacterial and anti-inflammatory are two different things. They will speed up your recovery."

The young man was stunned: "Isn't anti-inflammatory treatment just an injection?"

Lu Cheng said, "This is your understanding of anti-inflammation. Our understanding of anti-inflammation is not this. Anti-infection is anti-infection, and anti-inflammation is anti-inflammation."

“We don’t need to dwell on these things. By the way, brother, have you ever had any other illnesses before?”

"I asked you this question before, but you haven't answered it yet."

The young man's expression remained somewhat hesitant upon hearing this: "Does this really need to be asked?"

"Just ask me a standard question, and I'll tell you whether I have it or not," Lu Cheng said.

"Sigh..." The young man sighed upon hearing this: "Does infertility count?"

Lu Cheng opened his mouth slightly, then immediately said, "I'm sorry, brother, I was just asking routine questions to understand your situation more thoroughly, not to reopen old wounds."

Have you been to the hospital for a checkup and received a diagnosis?

The young man shook his head: "No, we've been married for several years but still don't have children. So my wife and I went to see a traditional Chinese medicine doctor and took a lot of medicine, but it hasn't helped..."

"Hey, I know there is." The young man's words immediately silenced the old man in bed 6 who was about to say something.

Lu Cheng and the young man exchanged glances.

"Brother, haven't you thought about going to a reputable hospital for a checkup?" Lu Cheng asked.

The young man said, "Actually, I've seen it before, and I don't have any problems."

“My parents said that according to the fortune teller, I was destined to have an only child, and it would be a son. But when I was young and ignorant, I adopted a godson, and that child’s place was taken.”

"There's no such thing. It's perfectly normal for healthy men and women to get pregnant."

"Perhaps it's just not meant to be," Lu Cheng said.

"Brother, if you don't have any other problems, I'll head back now."

Lu Cheng originally planned to use his spare time to accumulate skill points, but now it seems completely useless.

"Wait, Dr. Lu, can you read X-rays?" the young man suddenly asked.

"Oh, I know a little. What's wrong? You had some X-rays taken before?" Lu Cheng asked.

The young man was injured in a fall and may have had an X-ray taken.

The young man said, "It wasn't me, it was my wife. She said she had a cold and symptoms of enteritis. She even had a CT scan."

"I've been receiving treatment for a while now, but there haven't been any results." "I'm wondering if the doctors there aren't doing the right thing."

Lu Cheng quickly shook his head: "Brother, since my sister-in-law is hospitalized, she should listen to the doctors there. Compared to the doctors there, I'm a layman."

While Lu Cheng was speaking, the young man had already downloaded the film.

With the advancement of the internet, imaging data can now be stored in the cloud and accessed at any time.

Before Lu Cheng could dodge, the young man opened the CT scanner and placed it in front of him.

Lu Cheng hadn't paid any attention at first, but upon closer inspection, he discovered something extraordinary.

No, this CT scan belongs to my sister-in-law? That doesn't make sense.
What about the ovaries?
Lu Cheng needs to examine a girl very carefully to determine whether she has enteritis or not, but he can tell at a glance that a girl's ovary is missing.

"Dr. Lu, you're a professional too, could you please take a quick look at this for us, just to give us a reference?"

"What I mean is, if the treatment there doesn't work, we'll come to the state hospital."

“But my wife has always been unwilling to come,” the young man said.

Lu Cheng thought for a moment before saying, "Your sister-in-law doesn't want to come? Then you should ask her to come. She's been in the local area for so long without getting better. You should hurry up and have her come to the hospital."

Lu Cheng didn't know if the young man knew that his "sister-in-law" didn't have ovaries.

But if he knew, he wouldn't have mentioned his infertility. If he didn't know, to avoid directly causing family disputes, he would have to call someone over himself.

"That's what I think too, Dr. Lu. Have you figured out what the problem is?" the young man pressed.

Lu Cheng was looking at the images very carefully. After examining the CT scan closely, Lu Cheng really couldn't find anything unusual.

If there are special lesions that need to be treated at a higher-level hospital, then what Lu Cheng wanted to say would be simpler.

"I can't tell yet. A CT scan is just a relatively simple imaging examination. In this case, it would be best if you had your sister-in-law come over so you could both go and get it checked together."

“My suggestion is this,” Lu Cheng said.

Diagnosing enteritis is rather abstract, as it can be subdivided into many different types. CT scans can only locate the location, not truly characterize it. Perhaps a colonoscopy would be better.

"Okay, Dr. Lu. I'll call her right away. I was busy before, but I can rest now." The young man smiled.

Upon hearing this, Lu Cheng suddenly asked, "Brother, should I arrange a consultation with a reproductive specialist for you?"

"You're currently hospitalized, so this kind of consultation is covered by insurance."

Lu Cheng is an emergency room doctor, so he certainly can't determine the cause of the other person's 'infertility', but doctors in the reproductive medicine department are legitimate professionals.

If this young man actually showed the film to that doctor, the doctor would definitely yell at him, and perhaps that would be a roundabout way to achieve his goal.

Can I get reimbursed for this?

“Even if it’s not reimbursable, it’s still better than queuing up at the outpatient clinic. Of course, whether you ask for help or not is up to you,” Lu Cheng said.

“Alright then…” the young man nodded.

After returning to the doctor's office, Lu Cheng sent out a consultation request!

However, to Lu Cheng's surprise, the nurses' station received a call shortly after he sent out his consultation request.

"On-duty doctor, please contact the reproductive medicine department," a nurse at the nurses' station called out.

"Huh? Oh, okay." The other person reacted incredibly quickly.

Lu Cheng had just put the phone headset to his ear when a shrill voice came through: "Are you out of your mind? What kind of consultation are you asking for for a reproductive problem when you're hospitalized in the emergency room observation ward?"

"Can't you just let the patient go to the outpatient clinic on their own? DRG won't pass."

Lu Cheng: "...Okay, teacher, I'll cancel the consultation immediately."

Upon hearing this, Lu Cheng quickly apologized.

It's quite ridiculous for an emergency room doctor to need someone from the reproductive medicine department to explain DRG to me, but that's the current state of healthcare.

What can Lu Cheng do? Go and explain it to the patient again?

However, when Lu Cheng arrived, the patient was on the phone: "Come see a doctor! All the doctors here want you to come!"

"Money problems are easy to solve."

"No, Xiaomin, why do you react so strongly every time we take you to the hospital?"

"Ignoring your illness and refusing to seek medical help won't work. Crying won't solve anything."

The young man pressed for an answer.

"You brought up the issue of children again. I've said it before, and my attitude has always been that I don't force these things, but I also don't force them either."

"If you get pregnant, you give birth; if you don't get pregnant, you don't?"

"What does this have to do with you coming to see a doctor?"

The young man's expression suddenly changed drastically: "Huh? What did you say?"

Then, his eyes suddenly turned to look in Lu Cheng's direction with a very sinister look, while Lu Cheng's expression and gaze remained calm.

Immediately afterwards, the young man's deep voice rang out: "You saw the posts on WeChat Moments and the photos from the scene a few days ago, right?"

"Give me back my money, or your whole family will suffer the same fate!"

"I'll fuck your mother!"

Did you say that before?

"Get lost!" The young man immediately hung up the phone.

Immediately afterward, the young man turned around and looked at Lu Cheng, his anger seemingly directed at someone: "Did you figure it out just now? Why didn't you tell me?"

Lu Cheng calmly replied, "What do you think I've figured out?"

"That's the thing." The young man approached aggressively.

Lu Cheng remained calm and said, "You only came to me for treatment of enteritis?"

The young man rushed up to Lu Cheng, forcefully blinked, and looked furious!
Lu Cheng added, "The reproductive medicine department said they can't arrange a consultation and you have to go to the outpatient clinic yourself. I'm here to convey this fact to you."

"Brother, you can rest assured, I will absolutely protect your privacy. Leaking other people's privacy is illegal!!!!" Lu Cheng emphasized.

The young man's breathing began to calm down after it had become erratic. After thinking for a while, he suddenly said, "Thank you, Dr. Lu. Please process my discharge papers. I need to go back home."

Lu Cheng said, "Then you'll have no choice but to sign the discharge papers against your will. Come with me."

The young man said, "It's alright, it's none of your business if I die out there."

Lu Cheng paused: "Then don't leave. I need to go and ask my superiors."

"What's wrong? Why are you talking about dying all the time?"

"You make it sound so easy for you. You've never experienced anything like this yourself, have you?" the young man said, a little annoyed.

I don't know if she resented Lu Cheng for revealing the secret, lamented her bad luck, or secretly hated herself for being stupid.

Lu Cheng said, "The main thing is that I think you're still young, brother. Even if you lose some money, you still have a chance to make a comeback."

"no need."

"We live in a harmonious society now."

"Good health is the most important thing. If you're willing to believe it, go upstairs to the oncology department and you'll find that people like us who are healthy are already incredibly lucky."

"Besides, it's always better to know some things than to be kept in the dark forever!"

The young man said, "I want to be discharged! Let me be discharged quickly!"

Lu Cheng was even less likely to process it: "Your current condition does not meet the discharge criteria, so I cannot process your paperwork."

“I told you, I want to be discharged,” the young man said.

Of course, Lu Cheng's request was initially denied, but with the joint witnessing of several people, including superiors, the security office, and the medical department, he eventually completed the discharge procedures.

As the young man signed, Lu Cheng said again, "Brother, handle this calmly! This kind of concealment is fraud."

"Really?" The young man's eyes suddenly lit up.

“I was just guessing,” Lu Cheng said.

This knowledge came from a question that Huang Haibo, an internal medicine doctor at Longxian People's Hospital, mentioned occasionally during a joke. Lu Cheng had memorized it, intentionally or unintentionally.

"..."

(End of this chapter)