The Enhanced Doctor

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For these interns, having watched his small-incision appendectomy, they held some admiration for him. Now, being allowed to help treat patients so early on was very exciting and exhilarating for them.

In fact, everyone goes through such a process, starting from an excitation period and slowly transitioning into a weariness phase. Even Liu Banxia was a bit lazy with these minor tasks, now that he was no longer bothered by the system's daily tasks.

He darted between the two treatment rooms, observing one for a while then the other. He genuinely needed to assess the interns' proficiency levels.

Overall, they were all quite good, especially the lively Xu Yino and the shy Su Wenhao, whose suturing skills were the best. These two represented the extremes within this small team; the other four, though slightly weaker, weren't too far behind.

After all, standard surgical suturing doesn't involve many complex technical principles, and they had all mastered it well during practice in medical school.

Qi Wentai didn't comment on Liu Banxia's all-encompassing approach, even when it extended to guiding Qi's own interns.

He had no choice. Liu Banxia was now the chief resident, while he was merely a resident doctor. Although he had some autonomy, patients who truly needed surgery still required Liu Banxia's final approval.

It was something of a relief; all he needed to do now was seize every moment to practice his surgical skills and strive to surpass Liu Banxia.

"Dr. Liu, we just received a call. A patient, beaten unconscious, is being sent to us," Wang Ying said, approaching them.

"Dr. Qi, you and the team can receive the patient," Liu Banxia said.

Qi Wentai paused for a moment, then nodded. Even if this was an opportunity Liu Banxia was giving him, he wouldn't accept it gratefully.

After a short wait, a young man in his twenties was wheeled in on a gurney, accompanied by a weeping young woman.

"Assault trauma, blood pressure 75/110. He's already unconscious and has head contusions," the paramedic reported.

"Resuscitation Room 1. Family, please wait outside," Qi Wentai instructed.

Seeing the young woman about to follow into the resuscitation room, Liu Banxia stopped her. "Your presence will affect our rescue efforts. Can you tell us what happened?"

"Doctor, you must save Dongzi! It's all my fault, all my fault! I shouldn't have let him come," the young woman cried.

"Do we need to call the police? If so, I can contact them for you," Liu Banxia asked.

"I... I need to think about it. I have to ask Dongzi," the young woman said, wiping her tears.

Liu Banxia nodded. "Please wait here for now. I'll go in and check on the situation."

It was clear there was more to this situation. He couldn't take it upon himself to intervene; only the people involved could make that decision. Otherwise, he would be like Mei, just making things worse despite meaning well.

"How's the situation?" Liu Banxia asked upon entering the resuscitation room.

Qi Wentai reported, "Initial examination: breathing is currently stable, abdomen is soft, and there's a bruise on his left chest. Left-sided breath sounds are weak, and we suspect fractures in the left arm and leg. Blood oxygen is a bit low at 88. We've arranged for blood tests and crossmatching. X-rays will be done after the ultrasound."

"The ultrasound machine is here." Just then, a nurse wheeled in the portable ultrasound machine.

Without hesitation, Qi Wentai began performing an ultrasound on the patient's chest and abdomen.

"We need to perform a chest tube insertion; there are signs of pneumothorax. Doctor Liang, you do it," Qi Wentai said after examining for a while.

"Okay." Liang Xiaolin responded and immediately began the procedure.

Although Liu Banxia and the others had seen Liang Xiaolin perform chest tube drainage before, for these six new interns, witnessing her swift, decisive actions filled them with envy.

Liang Xiaolin was, in fact, their peer. Yet, because she had arrived a bit earlier than them, she handled such a critical procedure with such apparent ease.

"Blood pressure and oxygen saturation are rising. Send him for X-rays and CT scans of the head, chest, and abdomen," Qi Wentai said after Liang Xiaolin finished.

"Hold on a moment," Liu Banxia interjected.

Qi Wentai frowned, eyeing him cautiously. He knew this guy was up to no good. No wonder he let me handle the admission—he wanted to make me look foolish in front of these newcomers.

Liu Banxia walked to the bedside and lifted the patient's right and left hands; there was no response. He then removed the patient's shoes and lifted both feet, again with no reaction.

Everyone now realized Liu Banxia must have noticed something.

Liu Banxia then used a probe to test the patient's limbs. Fortunately, there was a response to pain, indicating the nerves were intact. He then examined the patient's left chest more closely and pressed on his sternum.

"Rib fractures have caused subcutaneous emphysema. Liang Xiaolin, intubate first to secure the airway before sending him for X-rays," Liu Banxia instructed.

"Wow... The blood oxygen really dropped again!" Xu Yino exclaimed as soon as Liu Banxia finished speaking.

Realizing her outburst was inappropriate, she quickly covered her mouth.

"Dr. Liu, the patient's jaw seems to be dislocated; I can't open it," Liang Xiaolin said, encountering a problem while preparing for intubation.

Liu Banxia went over and palpated the patient's mandible. It was indeed dislocated. However, for him, this was a simple fix. With a soft CRACK, he realigned the patient's dislocated jaw.

The rest of the procedure was straightforward. Liang Xiaolin had intubated patients many times before. Although this patient's condition was somewhat complex, the intubation was successful.

"Teacher Liu, how did you notice something was wrong with the patient?" Xu Yino asked after the patient was sent for imaging.

Hearing her question, the others pulled out their small notebooks, ready to take diligent notes.

"No need to be so formal. It's quite common for rib fractures to cause subcutaneous emphysema, especially in assault victims like this patient. Judging by the injuries, he was likely beaten for a long time," Liu Banxia stated. "Such blunt force trauma significantly increases the likelihood of subcutaneous emphysema. I didn't expect the jaw dislocation, though. Luckily, we caught it in time. Hmm, next time you encounter trauma patients like this, pay extra attention to protecting the airway. Let this case be a reminder."

"Teacher Liu, will we be able to perform on-site intubations in the future?" Xu Yino asked again.

"Don't be so ambitious. Intubating a real patient is very different from practicing on a mannequin," Liu Banxia said with a smile.

"Go home and think it over carefully. If you feel you're up to the task, tell me tomorrow. If a similar situation arises, I might let you try.

"But consider it thoroughly. I can give you many opportunities to try. As long as you succeed, there won't be any issues. However, if you fail, or if there are any flaws in your procedure, there's no telling when you'll get another chance for hands-on practice.

"We're surgeons; every procedure is crucial. I allow you to have confidence—that's fundamental for a surgeon. But you mustn't be blindly confident; that will harm the patient."

"Teacher Liu, what does 'blindly confident' mean?" Huang Bo asked.

"'Blindly confident? That's just being blindly self-confident. Hence, 'blindly confident,'" Liu Banxia said, deadpan.

"Being hands-on and daring to try is commendable. When a certain someone first arrived, I even scolded them until they cried," Liu Banxia said. "Pop quiz: if there are no further issues with the patient's chest and abdominal cavity, what are the next steps in treatment?"

Just as they were wondering if "a certain someone" was Liang Xiaolin or Qing Kewa, Liu Banxia's sudden question caught them off guard.

To Liu Banxia's surprise, the first to react was the usually timid Su Wenhao, who quickly raised his right hand.

"Alright, you tell us," Liu Banxia said, nodding at him.

"If there's no organ damage in the chest or abdomen, we still need to observe the X-rays and head CT results," Su Wenhao quickly answered.

"That's half right. Anyone else want to add to that?" Liu Banxia asked.

"Insert a urinary catheter and a nasogastric tube?" Liu Yiqing suggested hesitantly.

"Can I answer?" Qing Kewa asked, her interest piqued.

Liu Banxia glanced at her and nodded with a smile.

"Ask someone else for help!" Qing Kewa said eagerly.

Liang Xiaolin chuckled. "She means call an orthopedist for a consult. In her understanding, that's 'asking someone else for help.'"

Qing Kewa nodded vigorously; that was exactly what she meant.

"Exactly. The patient has fractures. Regardless of severity, we should call in an orthopedic doctor for a consultation," Liu Banxia said, laughing.

The six interns finally understood. Right, fractures mean calling an orthopedic attending for a consult. But while they understood, they shot Liu Banxia somewhat resentful glances, feeling they had fallen into his trap. His question about what to do if the chest and abdomen were clear had cleverly steered their thoughts in that direction. Well, they could at least tell themselves they'd just forgotten to consider the fractures.

However, they did learn a great deal from this patient today, even more than from the abdominal pain patient that morning.

When dealing with emergency patients, meticulousness is crucial. Overlooking even a small detail could endanger the patient. Teacher Liu was truly impressive, especially his swift and deft reduction of the dislocated jaw.

After another short wait, the X-rays and CT scans were all done.

The patient was relatively fortunate. Aside from the rib fractures, his injuries weren't particularly severe, though he likely had a mild concussion.

An orthopedic attending was called for a consult. There was some effusion in the left knee. They decided on conservative treatment and observation, hoping it would reabsorb on its own.

DING! Consultation completed.

Received 100 Experience Points, 150 Diagnostic Skill Proficiency Points, 50 Orthopedic Manipulation Skill Proficiency Points.

Liu Banxia was quite satisfied with this reward. The system's task rewards are definitely more targeted now. If he'd handled this alone, he'd have been lucky to get 50 diagnostic points. Teaching these students had clearly boosted the reward. It seemed combining teaching with leveling up would be quite effective.