Doctor of Healing

Chapter 793 Damn it, let him pretend again!
"Because omental infarction is a self-limiting disease and does not require surgery, it is fundamentally different from the treatment plan for acute appendicitis, so you refused to do abdominal CT, which made it impossible for us to investigate. According to the regulations, your signature is required."

After Ji Xiang finished speaking, he looked straight at Dr. Merz with firm eyes, with a hint of majesty of a superior doctor.

It is not a systematic skill, but Jixiang's undeniable majesty accumulated naturally after doing too many surgeries.

Ten seconds later, seeing that Dr. Merz didn't say a word, Ji Xiang continued, "Dr. Merz, if you don't have confidence in your diagnosis, I suggest you listen to us."

"!!!" Dr. Merz almost spat out a mouthful of old blood.

I came all the way to the Second Affiliated Hospital to trouble Lin Jiuze.

It's a pity that I met a big devil who restrained himself everywhere.

No matter what I do, I don't like it, and I don't even understand surgery.

He even got acute appendicitis out of nowhere, and the big demon king was so black-bellied that he didn't allow him to have an operation.

He is not a doctor at all!He is a big devil!A real big devil.

Dr. Merz cried out inwardly.

But Dr. Merz was so exhausted by the disease that he could not resist at all.

"Xiaoji, did CT do it?"

While chatting, Chief Bai opened the door and came in.

"Hello, Director Bai." President Zhao immediately lowered his head when he saw that Director Bai was on call like a summoned beast.

He thinks that today's things can no longer be good, and he regrets it a little.

It's all my own fault. If I didn't want to communicate more with Ji Xiangji Dashan, I wouldn't have asked him to be a "translator".

If he hadn't come to act as an interpreter, Dr. Merz would already be on the operating table, and Chief Bai would not have come at all.

If he had dragged Dr. Merz into the operation, he would probably have seen the appendix by now, and he could cut it off with just a few clicks, so there would be so much trouble.

What happened next was completely out of control, Mr. Zhao only hoped that Jixiangji Dashan would not make trouble out of control.

"Director Bai, we think the diagnosis is still open to question, and we recommend an abdominal CT. Dr. Merz doesn't sign it, but only asks for surgery, which is very difficult for us," Ji Xiang said.

"This is Lawyer Chu, the legal advisor I hired from the foreign affairs department." Director Bai pointed to a man in his 50s behind him and said, "Lawyer Chu, this is the Ji Xiang I mentioned to you. "

"Hello, Doctor Xiaoji." Attorney Chu reached out and shook Ji Xiang's hand.

He glanced at the doctor-patient communication document, greeted Director Bai, and asked Ji Xiang to go out with the document.

"It's hard to do. It's better to be cautious about some things." Attorney Chu chatted with Ji Xiang while reading the documents, "I work in a law firm, and a clerk under me has just been complained about."

"Why complain?" Ji Xiang asked.

"She answered a phone call from a person, and the clerk asked what the case number was, and the person immediately hung up the phone and complained. He meant that there must be something shady, otherwise why would he need a password."

"..." Ji Xiang felt that this lawyer Chu was a little interesting.

When they first met, they were a little awkward and unfamiliar, so he casually said a homophonic stalk to narrow the distance between himself and him.

This is EQ, and Jixiang feels very comfortable talking to people with high EQ.

"Not to mention, the patients you meet are almost similar to the plaintiffs and defendants we met." Attorney Chu looked at the communication written by Ji Xiang word by word, and continued to chat as if he could be single-minded and dual-purpose .

"Hehe, I didn't expect you to have so many troubles. I always thought that only doctors would encounter so many wonderful patients and their families."

"Yes, there are many unreliable things. For example, when I went to the law firm at this time last year, I saw an old man in his 80s leaning on a cane, swearing, and asked my assistant what was going on. The assistant Said that the old man’s children took all his money away.”

"Harmful." Ji Xiang sighed.

Lawyer Chu looked up at Ji Xiang, with the corners of his mouth raised, "Doctor Xiao Ji, do you think that children do not support the elderly?"

"Uh, isn't it?" Ji Xiang was taken aback.

"I thought so too at the time, but after learning about it later, I realized that it was the old man who learned how to surf the Internet and tipped female Internet celebrities on a live broadcast app. He spent tens of thousands of yuan a month, and his children saved all his money. Set a regular schedule and don’t allow tipping to female internet celebrities.”

"..."

"So, that's the way things are in this world. We've been lawyers for a long time, and we're used to all kinds of things in the world. It's said that there are more prayers heard on the walls of hospitals than churches, and our law firm is a little bit worse. , but it can be regarded as having seen the world."

"Teacher Chu."

"Huh?" Attorney Chu looked down at the communication written by Ji Xiang, and responded casually.

"Emperor Capital, is there a well-known lawyer who seems to have been slapped because of a dispute with the other party during the court session, and when he went for the medical examination later..."

Lawyer Chu was taken aback for a moment. He raised his head and narrowed his eyes.

"Knocked out 7 of my teeth."

"How do you know?" Attorney Chu was startled, then asked cautiously.

"I heard from a teacher in the imperial capital."

Lawyer Chu frowned, and nodded after a few seconds, "Everyone is suspicious, but there is no conclusive evidence. But having said that, Doctor Xiaoji, your communication documents are really well written."

Ji Xiang knew that lawyer Chu didn't want to mention such sensitive matters.

Originally thought that the empathetic experience in the system and the things mentioned by the system npc did not exist, but after asking casually and seeing Lawyer Chu's expression, Ji Xiang raised a trace of doubt.

"good."

"I've seen many of your doctors' communication problems, and you can be a template." Lawyer Chu said with a smile. What Ji Xiang just said seems to have been forgotten long ago, "You are young. But you are thoughtful, no wonder Director Bai values ​​you so much."

"It's fine."

"Well, I don't see any problem, let the patient sign."

Lawyer Chu then approached Director Bai who was communicating with Dr. Merz, and whispered his opinion in a low voice.

"Dr. Merz, I suggest you get a CT scan." Director Bai gently persuaded, "After all, we need to check for problems with a small probability."

"Small probability! I am a patient now, and I diagnose..."

"You are a patient now, but you have never been an expert in gastrointestinal surgery. If you insist, I suggest that you best contact your expert friend in Massachusetts." Ji Xiang interrupted Dr. Merz.

This is the second time that Dr. Merz has heard from Ji Xiang that he wants to contact an expert friend in Massachusetts.

As for the last time, it was a patient who was diagnosed with a patent foramen ovale.

Dr. Merz, who was firmly convinced that he was framed, targeted, and repeatedly rubbed under the feet of the Great Demon King, suddenly felt a little shaken.

"Dr. Merz, you used to be a doctor, but now you are a patient. Please put yourself into the perspective of a doctor and think about it."

Listening to Ji Xiang's words, Dr. Merz fell into deep thought.

"It is undoubtedly a disaster for people who are not professional or who think they are professional to participate in the professional field. You are a doctor and I think you understand all this."

Yes, that was indeed a disaster.

wrong!Dr. Merz realized that Ji Xiang was "yin and yang" himself in an instant.

That young big devil is saying he is unprofessional!
After making a simple diagnosis and treatment complicated, the unprofessional doctor himself tasted the bitter fruit in the final dramatic ending!
Dr. Merz was angry, very angry, very angry.

But when he and Ji Xiang looked at each other, he was directly discouraged, without expressing his anger at all.

The diagnosis of patent foramen ovale is still vivid in my memory. At that time, I waved the electrocardiogram sheet in front of the young big devil, but in the end I was slapped in the face.

Facts have proved that the patient is indeed a patent foramen ovale.

Not only that, after the operation, Wenbanyama seems to be getting better every day.

Dr. Merz was silent.

"Do you need a medical consultant?" Ji Xiang asked.

"Let me make a call." Dr. Merz was a little embarrassed.

Because he does not understand Chinese, there is no way to relay some inspection data.

"I can translate the data." Ji Xiang immediately saw Dr. Merz's embarrassment and suggested.

Damn!

Dr. Merz didn't feel that Ji Xiang was showing kindness to Ji Xiang's "magnanimity", but thought that the young big devil was suppressing himself.

At the same time, the pain in the abdomen intensified.

This is all the fault of the young Great Demon King!
Dr. Merz called a familiar gastrointestinal surgeon.

"John, there is something I want to ask you."

"Oh, where are you? I haven't seen you recently." The doctor on the other side of the phone asked.

"I... I seem to have acute appendicitis."

As soon as Dr. Merz said this, the phone was picked up by Ji Xiang.

The incident happened suddenly, and Dr. Merz didn't pay attention. When he wanted to get back the phone, he found that the young big devil had already started communicating with his friends.

The young big devil began to state his condition, which Dr. Merz could understand.

"On the B-ultrasound image, I saw bean-shaped oval-shaped masses appearing on the abdominal wall. There are not many of them, and they are not very clear."

Dr. Merz couldn't believe that was what a doctor said in a history report.

But Ji Xiang explained very seriously.

"Because I didn't do the B-ultrasound, so I can only make judgments based on the B-ultrasound image."

The doctor on the opposite side said something, and Ji Xiang listened attentively.

"I don't think it should be urgently diagnosed as acute appendicitis. Instead, abdominal CT and enhanced abdominal CT should be performed first to rule out the possibility of omental infarction. If the CT is confirmed, I suggest enhanced CT to determine whether surgery is necessary."

Dr. Merz was taken aback when he heard what Ji Xiang said.

Not only to do CT, but also to do enhanced CT, but I only got acute appendicitis!

If it was at Massachusetts General Hospital, the insurance company would never reimburse the money!
It was too much. The young big devil not only wanted to challenge himself, but also tried to challenge the experts and insurance companies far away in Massachusetts General Hospital.

"Okay, I'll give the phone to Dr. Merz, and you tell him. Dr. Merz doesn't listen to my judgment, and he insists on surgery. You know, it doesn't matter whether the right lower abdomen is cut open or the abdominal cavity is done. Mirrors cannot meet the needs of surgery.

What's more, if there is no problem with enhanced CT, it is definitely unacceptable to perform surgery on self-limited diseases. "

With that said, Ji Xiang handed over the mobile phone to Dr. Merz.

"John..." While Dr. Merz was speaking, the person on the other end of the phone interrupted him.

"Merz, who is the person who just explained his condition to me?" asked the doctor on the other side of the phone.

"..." Dr. Merz glanced at Ji Xiang.

The angle of view curled up on the examination bed was different from the normal angle of view. Dr. Merz saw that the young big devil was so tall and invincible.

Is it really appendicitis?A tinge of doubt crept into Dr. Merz's mind.

"It's the chief surgeon who operated on Wenbanyama."

Dr. Merz revealed Ji Xiang's identity in a low voice.

"Damn it!" Dr. John scolded, "Why would a sports medicine doctor see a B-ultrasound?"

"I can do it too."

"No! Merz, B-ultrasound of retinal infarction is difficult to judge. The best way is to do CT. Remember the trouble I encountered a few years ago?"

Dr. Merz froze.

He vaguely remembered, but John didn't say the specifics of the matter.This is privacy, and Dr. Merz didn't ask carefully.

"A patient's examination was considered to be cholecystitis. The hepatobiliary doctor performed an operation and found that the patient's gallbladder was fine and there was no problem at all. The problem was the patient's greater omentum."

"!!!"

"This damn disease looks so similar to appendicitis and cholecystitis, and there is no way to check it without abdominal CT. But the insurance company firmly disagrees with reimbursement for related patients."

Dr. Merz did not expect that his friend would completely stand on the side of the big devil.

"You don't understand the details here, I suggest you listen to the opinions of local experts."

After speaking for a long time, Dr. John firmly gave his opinion.

"Why do you think he's an expert?" Dr. Merz asked.

His voice was extremely low, for fear that Ji Xiang could hear him.

But Jixiang has good hearing and can hear clearly.However, Jixiang didn't have any bad thoughts about Dr. Merz because of this. Patients questioned him a lot, as long as he is willing to do CT.

What Jixiang thinks more is that there is absolutely no need for enhanced CT, otherwise the operation will be very difficult, and I am afraid that no one in the Second Affiliated Hospital has experience.

Everyone is safe and sound.

"Melz, you stupid bastard, you want to stuff my leftover sandwich in your mouth!"

"..."

"There is no reason, you can just listen to the opinions of the experts. I still have a damn operation, and I haven't finished the outpatient volume for this month. If I have to go fishing on the weekend, I will go to the outpatient clinic to see those patients after the operation." Boring patients make up enough outpatients for this month.

Merz, do you know how busy I am! "

Dr. Merz reluctantly heard a blind tone from the opposite side, and then hung up the phone.

"Doctor Merz, do you want to do a CT scan or sign a refusal?" Ji Xiang waved the communication in his hand.

"..." Dr. Meltz looked helplessly at the big devil who was showing his might in front of him, speechless.

Let him pretend again!

Damn!

Omental infarction, Dr. Merz vaguely knew that the disease should involve blood vessels.

But it’s all right, once something happens, assuming that there is no blood supply to the omentum in a large area, the next step is acute abdomen!
If the diagnosis and treatment are delayed, then there will be difficult-to-treat diseases such as bacteremia, and there is a high probability of infection, toxic shock, and even life-threatening.

It will definitely not be as simple as acute appendicitis.

Thinking of this, Dr. Merz became a little anxious.

"I want to do CT! Enhanced CT!!"

After finishing speaking, Dr. Merz added, "It doesn't matter if the insurance company doesn't reimburse you, I'll pay for it myself!"

The fear of large-scale necrosis of the omentum has exceeded Dr. Merz's idea of ​​defeating the young big devil in front of him. Enduring the severe pain in his abdomen, he almost wailed and said.

"What did he say?" Director Bai asked.

"Dr. Merz agreed to do CT, but he still needs to do enhanced CT." Ji Xiang felt helpless.

"Need me to contact you?"

There is no doctor on duty for enhanced CT at night, because this examination is not an emergency item.

If it is necessary to do it, director Bai needs to call the relevant doctors from home and start the machine to prepare.

Ji Xiang thought for a while, "Let's call it. Although I think it's unlikely, what if? An expert from Massachusetts General Hospital died of illness in our hospital. It's hard to say."

"!!!"

The last sentence shocked Director Bai.

It is not an exaggeration to say that the consequences were disastrous.

Director Bai even thought of the series of chain reactions caused by the "death" of the Massachusetts expert in the Second Affiliated Hospital, and his scalp went numb.

Contacted the CT room, Director Bai took someone to send Dr. Merz, the "big trouble", for an examination.

CT images showed a large area of ​​fat density shadow with blurred edges and unclear boundaries.

This is wool?

The doctor on duty in the CT room looked at the image in doubt, he had no idea how to make a diagnosis.

"It's an omental infarction." Ji Xiang said with certainty, "But for the time being, there is no need for surgery, just observe it for a few days."

Director Bai asked anxiously, "Really? Anyway, Director Niu of the CT room is coming, so he can do an enhanced CT by the way?"

Ji Xiang did not insist, but agreed with Chief Bai's opinion.

Anyway, I just need to rest. Seeing Dr. Merz's omental infarction is a self-limiting disease.

It doesn't matter to me or to Dr. Merz's disease whether to do enhanced CT or not, but it can buy peace of mind for Director Bai.

After experiencing empathy countless times, Ji Xiang subconsciously thinks about problems from the perspective of others.

When Director Niu rushed over, he came to the same conclusion as Ji Xiang after seeing the video, and Director Bai was relieved.

However, he still insisted on having an enhanced CT.

Dr. Merz was doing the examination. Hearing the buzzing sound, Director Bai asked, "Director Niu, it's okay without surgery. What's going on?"

"Director Bai, the omental infarction you understand is omental thrombosis or something like that."

"En." Director Bai nodded.

"In fact, primary omental infarction often occurs in children and adults. The pain is often located in the right upper or lower abdomen, and it is easily misdiagnosed as appendicitis or cholecystitis. The only predisposing factor is obesity in children."

"I read a report saying that about 0.3% of patients with acute appendicitis were wrongly diagnosed, and omental infarction should be diagnosed."

Director Bai really doesn't understand this matter.

Also, it is impossible for a neurosurgeon-born medical director to be omniscient.

He listened carefully to Director Niu's explanation of omental infarction.

"Primary infarction is prone to occur in the right upper abdomen, which may be related to the longer and greater mobility of the greater omentum there."

"The lower abdomen is not uncommon, and most of them are self-limiting diseases, and you can just raise them for a few days."

"So looking at things like appendicitis and conservative treatment of cholecystitis, I think it's better to have a CT scan."

"However, it has already been said that we have abused CT. After the blood is drawn for B-ultrasound, another CT scan is required. It is estimated that 99.7% of appendicitis patients cannot accept it."

Director Niu said, laughing.

"Do you need surgery?"

"The omentum has a lot of blood vessels that don't generally need it."

Director Niu began to show off his skills, and he explained to Director Bai what kind of omental infarction that really needs surgery is like.

Ji Xiang stood in the corner and looked at the screen, waiting for the result.

As Director Niu said, this disease generally does not require surgery, and Dr. Merz does not need surgery.

Most cases of omental infarction are discovered during emergency surgical exploration, and they are all opened anyway. If it can be removed easily, it is generally recommended to surgically remove the infarcted omental tissue.

Surgical resection of the infarct can quickly improve the symptoms and signs of the patient, and the patient recovers faster and the course of the disease is shorter.

Laparoscopic resection of the infarcted local omentum can more effectively reduce postoperative complications such as pelvic-abdominal abscess, pelvic-abdominal adhesions, and intestinal obstruction.

After conservative treatment, the local inflammatory response can gradually subside in patients with mild disease, and the omentum gradually shrinks and becomes fibrosis. Most patients basically recover within two weeks, and some symptoms and signs can last for several weeks. CT and B-ultrasound reexamination can show that the mass gradually shrinks and the boundary is clearer.

As for how Dr. Merz's omental infarction came about, Ji Xiang had no idea.

Maybe it was caused by his overeating, or maybe it was caused by his bad mood and high blood pressure, who knows.

Ji Xiang doesn't care how Dr. Merz's illness came about, as long as he doesn't need surgery.

In case of surgery, according to the system npc, it doesn't just need to be removed, there will be very troublesome follow-up problems.

However, Dr. Merz seemed to have good luck. After the enhanced CT image came out, Ji Xiang breathed a sigh of relief.

It is the same as the display in the operating room of the system, no surgery is required, conservative treatment is enough.

Telling Dr. Merz the result, he was still very worried and asked for video data to be sent back to Massachusetts General Hospital.

Ji Xiang could clearly feel the difference in Dr. Merz's attitude before and after.

But it's normal, Jixiang has been a patient many times.

"Dr. Mertz, have you been in a big mood swing lately?" Ji Xiang asked on the way to send Dr. Mertz back.

"..." Dr. Meltz was taken aback.

He thought that he would experience abdominal pain after learning that Wenbanyama had received a call from Jenny Buss, with a high probability of going to the Lakers.

How did Ji Xiang know? !

"Although the cause of primary peritoneal infarction has not been determined, many patients are caused by fluctuations in blood pressure. I am very surprised that your blood pressure should be regulated very well. Why does it suddenly fluctuate?"

Dr. Merz felt that after the big devil knocked him down to the ground, he kept smacking his face, asking himself if he knew what was wrong while doing it.

F***! ! !

(End of this chapter)