Healing Doctor

Chapter 304 Let's Make a Bet (The Alliance Leader Saw My Master - Bonus Chapter x4)

"Xiao Ji, doctor." The internist addressed Ji Xiang with a strong pause, "Dr. Meng, why are you in such a hurry? What do you think is wrong?"

"There is subcutaneous emphysema under the armpit, which is suspected to be mediastinal pneumothorax."

"Mediastinal emphysema?!" Dr. Li from the internal medicine department chuckled, his tone slightly sarcastic. "Young man, did you see any external injuries on the patient?"

"no."

"No external injury, and you're diagnosing spontaneous pneumomediastinum? Tell me, where did it come from?" Dr. Li, an internal medicine specialist, sneered.

In his view, Ji Xiang was the kind of young man who knew a little about clinical knowledge, but only half of it, and who would blurt out all sorts of strange and unusual diagnoses.

Ignorance is bliss; some people learn a little and then start talking without thinking.

"Esophagus," Ji Xiang said with certainty.

He was lectured by the system NPC in the system's operating room and wanted to come out and say something. But Meng Qingfei understood immediately, touched him, and directly told the general thoracic surgeon to prepare a hospital bed.

Being too clever isn't good either; Ji Xiang had a lot to say but didn't know where to begin.

Ji Xiang wasn't trying to show off, but rather to "review" something.

"Spontaneous esophageal rupture? Hahaha, have you ever seen one? Or did your teacher talk about it back in school?" Dr. Li, an internal medicine specialist, laughed out loud, like a goose quacking.

"Spontaneous esophageal rupture refers to a full-thickness rupture of the esophageal wall caused by non-traumatic factors. Because its clinical manifestations are nonspecific, it is often misdiagnosed as angina pectoris, acute myocardial infarction, aortic dissection, acute pancreatitis, etc."

"..." Dr. Li, an internal medicine specialist, hadn't heard such professional language in a long time, and it sounded incredibly strange to hear it coming from a student.

He wanted to refute, but everything Ji Xiang said was right, and he didn't know where to begin.

"What's the cause? It can't just rupture like that out of nowhere. You know, the esophagus is elastic, and spontaneous rupture is very rare. At least in all my years of medical practice, I've practically never seen one," Dr. Li asked after a moment's hesitation.

"The main cause is severe vomiting after drinking alcohol or eating a large meal. The negative pressure in the thoracic cavity creates a pressure difference between the inside and outside of the esophageal wall. Since the esophagus is not protected by a serosal layer, especially the lower esophageal wall, which has a thinner smooth muscle layer, the lower segment is more easily torn."

As Ji Xiang spoke, he looked at Dr. Li with a puzzled expression.

"Teacher Li, the cause of the illness is very clear, there shouldn't be any doubts."

"..." Dr. Li wanted to curse.

Ji Xiang couldn't understand either. He had explained it so clearly, so why didn't Dr. Li from the internal medicine department understand?

"The main symptoms are: severe vomiting followed by chest pain, chest tightness, difficulty breathing, mediastinal emphysema, and subcutaneous emphysema. Vomiting → chest pain → subcutaneous emphysema is a typical triad."

"The patient has a slight feeling of snow under his armpit. I think Dr. Meng has already made a diagnosis. We are just waiting for a CT scan to show mediastinal pneumothorax so that he can be transferred to a general thoracic thoracotomy."

"Tch." Dr. Li, an internal medicine specialist, wasn't intimidated by Ji Xiang. He scoffed, "What a coincidence! In our internal medicine department, we get people who've had too much alcohol or taken too much medication coming to the emergency room for gastric lavage almost every day. Do you know how often we see a case of esophageal rupture?"

Ji Xiang sensed the displeasure in Dr. Li's words, but didn't argue with him; he just smiled.

After repeating what the system NPC had said, Ji Xiang gained a deeper understanding of the illness.

"We don't see a single case in a year!" Dr. Li from the internal medicine department said, raising his voice. "They're given fluids, and the patients vomit and gag, and they're under so much pressure, but nothing happens. You young man, you think you've seen everything in clinical practice just because you've learned a little from books. You're so ignorant."

"The symptoms match perfectly, Teacher Li."

"Let's make a bet," Dr. Li from the internal medicine department smiled. "If you diagnose correctly, I'll handle all the minor ailments that come in from the surgery department late at night."

"If you make a wrong diagnosis, you'll have to work three shifts with me."

Dr. Li, an internal medicine doctor, envied Meng Qingfei for having Ji Xiang's help. He then revealed his true intentions.

Dr. Li, an internal medicine specialist, was certain of victory.

"Okay," Ji Xiang said with a smile. "Professor Li, regarding the minor surgical procedure..."

"Actually, many treatments in internal medicine and surgery are quite similar," Dr. Li, an internal medicine specialist, said dismissively. "I definitely won't get involved in major emergencies, but I handle patients with appendicitis and cholecystitis myself without consulting a surgeon."

"Who would come to remove the stitches in the middle of the night? Besides, what's so difficult about removing surgical stitches?"

As he spoke, he laughed and said, "Young man, let me teach you a lesson today. The things written in books are rarely encountered in clinical practice. What we commonly see are only about 2% of the diseases mentioned in books."

Ji Xiang remained silent. Seeing Ji Xiang's silence, Dr. Li from the internal medicine department became even more convinced that he was right and had already won against the young man. He then began to talk to Ji Xiang at length about common clinical topics.

Half an hour later, Meng Qingfei returned with the flatbed cart.

"Xiao Meng, where is the patient?" Dr. Li from the internal medicine department asked.

"They've been sent for general thoracic surgery," Meng Qingfei replied.

Dr. Li, the internal medicine specialist, was taken aback. "What illness are you diagnosing?"

"Spontaneous esophageal rupture, mediastinal pneumothorax," Meng Qingfei said. "The patient drank some alcohol at noon and vomited twice, which ruptured the esophagus. The doctors at the lower-level hospital made a mistake and insisted it was acute myocarditis."

"..." Dr. Li from the internal medicine department was stunned. He hadn't expected to actually encounter a patient with a spontaneous esophageal rupture.

"Finished, that's a wrap!" Meng Qingfei went to wash his hands, and after coming out, he vigorously wiped his buttocks on his white shirt.

His white clothes were newly changed and were clean everywhere else, except for two black marks on his buttocks, which were quite conspicuous.

Ji Xiang didn't know why Meng Qingfei, who frequently washed his hands and seemed very clean, always wiped his hands on his white coat, and always in the same spot.

Instead of mocking Dr. Li from the internal medicine department, he respectfully said, "Teacher Meng, I'll go back and rest now."

"Go ahead, you have work to do tomorrow. I'll go home and rest after get off work tomorrow, it's different," Meng Qingfei replied casually.

"Xiao Meng, go to sleep. I'll keep an eye on things if there's an emergency in the middle of the night," Dr. Li from the internal medicine department said helplessly.

"Oh ho, Old Li, why are you being so merciful today?" Meng Qingfei asked curiously.

Although Dr. Li from the internal medicine department didn't say anything, being able to avoid doing sit-ups during shifts and instead lie down and sleep peacefully for an hour or two is a good thing for emergency room doctors.

Ji Xiang waved goodbye and walked out of the emergency department.

As the night deepened and all was quiet, the parking lot of the Second Affiliated Hospital was much less crowded, and the night breeze was slightly chilly.

Ji Xiang greeted the burly man in the darkness, but instead of going home, he patted his pockets.

With his pockets empty, Ji Xiang scratched his head.

He often went to the operating room and chatted with Colonel Wang and the others. Ji Xiang had gotten into the habit of smoking a cigarette while thinking.

I'll buy a box when I have time.

Although Ji Xiang knew this habit was bad, he had unknowingly been led astray.

(End of this chapter)