This miracle doctor just wants to be fired!

Zhao Wenqi quickly completed the hospitalization procedures and, together with another nurse, helped the young man with a fever pack his things and pushed his wheelchair to the endocrinology department.

Zhou Cheng felt a huge weight lifted off his shoulders.

This morning, the two most challenging patients were taken to the operating room and transferred to the endocrinology department, so things have finally come to a temporary end.

As soon as he turned around, he saw Fang Hang standing by the hospital bed not far away, holding a medical record book in his hand, looking at the patient on the bed with a furrowed brow.

That looks like a patient who has just arrived at the observation room.

The patient was an elderly man in his sixties who complained of chest tightness and palpitations. Fang Hang had been listening to his chest for a long time but still couldn't reach a conclusion.

Zhou Cheng was about to go over and take a look when Fang Hang looked up and saw him first. There was some hesitation in his eyes, but he still stepped forward and said, "Junior brother, are you done with your work? Could you take a look at this patient for me? I'm a little unsure."

Fang Hang's attitude was no longer as cold as before.

"Okay, I'll go take a look." Zhou Cheng nodded and followed Fang Hang to the bedside.

The old man leaned against the headboard, his face slightly cyanotic and his breathing a little rapid.

Seeing Zhou Cheng approach, he forced a smile: "Doctor, I still feel tightness in my chest and can't breathe properly."

Zhou Cheng bent down and first felt the old man's pulse.

The pulse was weak, but the frequency was fairly regular. I then picked up the stethoscope and listened to the heart and lungs.

No obvious moist rales were heard in the lungs, but the heart sounds seemed somewhat faint and distant.

He looked up and asked Fang Hang, "Senior, did you check the patient's electrocardiogram and cardiac enzymes? What's their blood pressure?"

"The electrocardiogram was just done, and no obvious myocardial ischemia was seen. The myocardial enzyme results are not yet available. The blood pressure is 100/65 mmHg, which is not high."

Fang Hang quickly handed over the electrocardiogram report, frowning as he said, "I initially thought it was coronary heart disease, but the electrocardiogram doesn't support it, and it doesn't look like a lung infection either. I don't know what the problem is."

Zhou Cheng took the electrocardiogram and examined it carefully.

As Fang Hang said, the electrocardiogram did not show typical ST-T segment changes, and it did not appear to be myocardial ischemia.

But he suddenly noticed that the QRS complex on the electrocardiogram was slightly lower than the normal range.

Normal people might not pay attention to the subtle changes in voltage on an electrocardiogram.

But Zhou Cheng was very perceptive and immediately noticed that the voltage had dropped!

Seeing Zhou Cheng's expression, Fang Hang quickly asked, "Junior brother, is something wrong?"

Zhou Cheng looked up at Fang Hang and said slowly, "The patient's heart sounds are distant, the QRS waves are low voltage, and he has symptoms of chest tightness. Although these are not typical, we cannot rule out the possibility of pericardial effusion."

Fang Hang paused for a moment, then slapped his forehead: "Right! How come I didn't think of pericardial effusion!"

He was so focused on coronary heart disease and lung disease that he forgot about this possibility!

Fang Hang has limited clinical experience, and when encountering atypical symptoms, he is still prone to falling into the mindset of common diseases.

Zhou Cheng continued, "The patient may need a CT scan or ultrasound. If it is indeed pericardial effusion, a small amount can be observed, but a large amount will require puncture and drainage. We cannot delay."

"Great!" Fang Hang suddenly understood.

……

Over the next few hours, this role reversal scenario played out repeatedly.

For every patient Fang Hang sees, he first makes a preliminary assessment himself, then goes to Zhou Cheng to explain the condition in detail and ask for Zhou Cheng's opinion.

"Junior brother, this lady is coughing up blood, and the chest CT scan didn't show any tumor. Could it be bronchiectasis?"

"Take a look at her sputum. Is it layered? If the sputum is layered, and there are signs of bronchiectasis on the CT scan, we can basically make a diagnosis. Also, do a sputum culture to see if there is an infection."

"Junior brother, this young man's stomach is bloated. We took an abdominal X-ray, but we didn't see any gas-fluid balance, which doesn't seem like intestinal obstruction. Could it be indigestion?"

"Ask him if he has eaten anything unclean recently, or if he has constipation. If he has constipation, it may be fecal impaction. Although it is not visible on the abdominal X-ray, you can try an enema to see if it can relieve the problem."

Zhou Cheng was also very open-minded, patiently helping Fang Hang analyze his condition each time, pointing out details he might have overlooked, and giving specific suggestions.

Fang Hang listened very attentively and even took out his notebook to write down all the key points Zhou Cheng mentioned.

The nurses in the observation room witnessed all of these scenes.

Zhao Wenqi leaned closer to Zhou Cheng and whispered, "Dr. Zhou, compared to Dr. Fang, you seem more like a PhD."

Zhou Cheng smiled helplessly: "Don't talk nonsense. I'm just helping to analyze it. Senior brother has a good foundation, but he lacks clinical experience."

On the other hand, the more Fang Hang interacted with Zhou Cheng, the more he realized how strong Zhou Cheng's clinical skills were.

Zhou Cheng could pinpoint the subtle symptoms that he hadn't noticed and the differential diagnoses that he hadn't considered.

Just then, the phone at the observation room nurses' station rang again.

Zhao Wenqi immediately stepped forward to answer the phone, said a few words, and quickly hung up. She then called out to Zhou Cheng, "Dr. Zhou! A call came from the operating room saying the surgery on the patient with the mesenteric embolism was successful, and they've been transferred back to the ICU!"

"Okay, I understand!" Zhou Cheng was overjoyed.

The surgery was successful, which means that his efforts today were not in vain.

Fang Hang also breathed a sigh of relief. This patient was his first patient, and if anything went wrong, he might bear some responsibility.

……

Around noon, the cardiology department called to say that they had available beds and could transfer the patient who stayed yesterday there.

Zhou Cheng was also happy to complete the hospitalization procedures and sent the patient who had stayed yesterday to the cardiology department.

"Junior brother, come quick and take a look! It really is pericardial effusion!"

At this moment, Fang Hang suddenly called out to Zhou Cheng.

Zhou Cheng was about to leave work and go to the cafeteria for dinner when he heard Fang Hang's voice and came over.

On the computer screen, Fang Hang had already pulled up the patient's chest CT scan that had just been performed.

Zhou Cheng leaned over the screen, picked up the mouse, and zoomed in on the image details.

Sure enough, the fluid-filled dark area in the pericardial cavity was clearly visible, and it was about a moderate amount, which explains why the patient felt chest tightness.

In fact, there is a small amount of fluid in the pericardium of a normal person, which plays a lubricating role.

However, when the pericardial cavity contains more fluid, it can compress the heartbeat and affect cardiac function.

Zhou Cheng looked at Fang Hang beside him: "Senior brother, how is the patient now? Has the chest tightness worsened? Are the blood pressure and heart rate still stable?"

"I just checked your blood pressure, it's 95/60 mmHg, a little lower than before. Your heart rate is 98 beats per minute, and you still feel some chest tightness, but it's much better than this morning," Fang Hang quickly said. "Junior brother, now that it's diagnosed as pericardial effusion, what should we do next? Should we perform a puncture and drainage first, or should we start medication and observe?"

Zhou Cheng thought for a moment and then said, "The patient has underlying coronary heart disease. The cause of the pericardial effusion could be tuberculosis, a tumor, or it could be leakage caused by heart failure, or it could be caused by hypothyroidism. Further examination is needed to determine the nature of the effusion."

"However, the patient's blood pressure has dropped a bit now, and the amount of fluid accumulation is quite large. If it continues to increase, it may compress the heart and cause cardiac tamponade. We need to arrange pericardiocentesis and drainage as soon as possible to relieve the symptoms."

"Let's contact the cardiology department first. If there are any available beds, it would be best if we could admit you."

Fang Hang immediately nodded: "Okay! I'll contact the cardiology department right now and have them send a doctor over for a consultation to see if I can be admitted to the hospital and arrange a biopsy!"

After saying that, he immediately took out his phone and started contacting a cardiologist for consultation.

After a busy morning, Fang Hang has gradually become familiar with the rhythm of the emergency observation room.

However, he also got used to listening to Zhou Cheng's advice, and even felt that with Zhou Cheng by his side, even decision-making became easier.