The Enhanced Doctor

Returning from his meal, Liu Banxia felt somewhat uneasy, still troubled by his thoughts about the promotion task. Just as he had once guessed, he was now worrying whether the difficulty would increase significantly when he reached level sixty or eighty.

Things had changed since he had just obtained the system; back then, it was effortless to level up. Now, in no time, he was about to reach level 40. In the future, as the experience required for upgrading increased, and the experience gained from tasks decreased, leveling up would become much more challenging.

Take the patient from today for example; in his understanding, the case could be classified as a complex and puzzling one. Making a definitive diagnosis was quite difficult. If he hadn't chatted with the patient, he might have had to delay his diagnosis further.

However, how did the system see it? For it, this was just a regular, minor patient intake task. The patient's indications were actually quite clear; it was just that he hadn't diagnosed it immediately.

Therefore, the difficulty of admissions was not primarily based on his understanding but on the system's judgment. That was also the reason why there were no additional tasks for him.

With his diagnostic skills leveling up again, he was starting to doubt whether ordinary admissions could even raise his skill points anymore.

"Banxia, prepare for admissions. Car accident victims, a family of three. The husband and son are in critical condition. The wife is temporarily fine," Wang Ying said, coming over to Liu Banxia, who was still deep in his thoughts.

"Sister Wang, please call Dr. Shi and Wang Chao for me. The rest of you, prepare for admissions," Liu Banxia said.

The conditions of the patients were not very clear at the moment, and he was unsure about the severity of the injuries sustained by the husband and son. From Wang Ying's use of the word "critical," it didn't seem as if the injuries were minor.

After waiting for about ten minutes, the ambulance stopped in front of the Emergency Department entrance.

"The patient is 41 years old, blood pressure 60/90, heart rate 110. He fell into a coma after the car accident, suffered head trauma, and his left arm is fractured," said the paramedic pushing the gurney.

"Resuscitation Room One. Dr. Shi, you and Wang Chao take the next patient," Liu Banxia said, then pushed the gurney toward Resuscitation Room One.

"Doctor, you have to save him! If something happens to him, my son and I won't survive," the patient's wife said anxiously, following them into the room.

"Does the patient have any medical history? Diabetes, hypertension, heart disease?" Liu Banxia quickly asked.

"No, none at all," the patient's wife hurriedly replied.

"Wait outside for a bit. I'll call you if necessary. One, two, three, lift," Liu Banxia said.

"Xu Yino, protect the airway. Xu Dan, connect the monitor. Prepare for a CBC, blood chemistry panel, cross-matching, mobile ultrasound, and a defibrillator. Establish an IV line, start IV fluids, and prepare two units of O-negative blood."

After that, he began to check the patient's head injury. It was merely a simple laceration that needed a few stitches. Whether there was any brain damage would have to be determined by a CT scan.

Palpating the abdomen, Liu Banxia frowned. The patient's blood pressure was too low. Coupled with the tactile feedback from his hands, there might already be internal bleeding.

"IV line established. Starting fluid resuscitation."

"Blood pressure 60/90, heart rate 110. Blood pressure hasn't risen."

"Start a blood transfusion when the blood units arrive. I'll check his arm first," Liu Banxia said.

The patient's left arm was twisted outward, a testament to the force of impact during the car accident. After Liu Banxia carefully palpated it, his frown deepened.

"Call an orthopedic doctor for a consultation. There are two fractures at the distal end of the radius that require surgical repair," Liu Banxia said.

If it had been a simple fracture, Liu Banxia could have handled it by performing a reduction and then applying a cast. However, this patient's fracture was beyond his current capabilities. He could perform the surgery, but he wasn't qualified enough.

The mobile ultrasound was brought in at this point, and Liu Banxia didn't delay. After applying the couplant, he started the examination.

"There's a small amount of fluid accumulation in the abdomen. Based on the steering wheel imprint on the patient's abdomen, internal bleeding is possible," Liu Banxia said.

"After the transfusion, the patient's blood pressure improved to 80/100, heart rate 105. Vital signs are stabilizing," said Xu Dan, who had been keeping an eye on the monitor.

"That's good news. Book an OR, take the patient for an urgent X-ray, and then take him directly to the operating room. Liang Xiaolin and Xu Yino, follow him with an intubation kit," Liu Banxia said.

He felt somewhat reassured. Even if there was internal bleeding, it seemed to be controlled for now. There wouldn't be time for a CT scan, but an X-ray of the broken arm could at least prevent the need for a second surgery.

"Sister Wang, how is the other patient?" Liu Banxia asked as he walked out of Resuscitation Room One.

"No visible injuries, just abdominal pain. The ultrasound isn't clear, so Shi Lei is taking him for a CT scan," Wang Ying said.

"What was that arguing I heard outside a while ago? Why haven't the police left yet?" Liu Banxia asked curiously.

"Sigh… this family is really having a tough time. From what they were saying, it seems the patient you were just treating drove his car into someone's shop," Wang Ying said.

"Thankfully, no one inside the shop was injured, but someone will have to pay for the damaged door, counter, and goods inside. Right now, they're waiting on our blood test results to see if he was driving under the influence of alcohol or drugs."

"The police said they also have to wait for the car's inspection results to see if it was due to a malfunction. But the patient's wife said he was just driving, then suddenly turned the steering wheel and floored the accelerator."

"Alright. I'll go to the operating room to prepare. Let the patient's family wait outside the OR. I'll communicate with her if necessary," Liu Banxia said.

This situation was indeed distressing. But from Liu Banxia's perspective, surely no one would be that irresponsible, especially with their family in the car, right?

Of course, the specific reason the patient drove the car like that had little to do with the hospital. Regardless of the cause, they had to treat and save the patient.

But now, with the patient's wife present, she was the one who could authorize the surgical procedure.

The four he brought into the operating room were Liang Xiaolin, Qing Kewa, Liu Yiqing, and Xu Yino. He also instructed the other four interns that if the pediatric patient on Shi Lei's side didn't need surgery, they should come straight to his OR.

They needed to communicate constantly to ensure everyone learned something. Otherwise, with so many people crowding into one operating room, some wouldn't be able to see clearly.

"Ah, it's Brother Wang again!" After scrubbing in and entering the operating room, Liu Banxia chuckled in surprise to see Wang Lei again.

"What's the patient's condition?" Wang Lei asked.

"Likely internal bleeding, but his vital signs are stable now, so he was sent for an X-ray first. He has an arm fracture; we're aiming to address it all in one surgery. The blood test results will be here soon," Liu Banxia said.

Wang Lei nodded. "That's more like it. Otherwise, if the data isn't comprehensive, my job here would be too difficult."

As they were talking, the patient was wheeled in.

"Teacher Liu, after the X-ray, the patient developed difficulty breathing and was intubated," Xu Yino said.

Liu Banxia nodded.

"Dr. Liu, what do you need me to do? Internal fixation?" Wu Mingyu, the orthopedic attending, also walked in at this time.

"Take a look at the X-rays that just came out. If it's a minor problem, I wouldn't have bothered you; I'd just set it and cast it myself," Liu Banxia said.

"Banxia, the patient's blood sugar is somewhat low. You should pay attention to that," Wang Lei said.

"Liu Yiqing, what are the possible reasons for hypoglycemia?" Liu Banxia asked.

"Functional or hepatic causes, as well as pancreatic and other endocrine diseases," Liu Yiqing quickly replied.

"Considering the patient's test reports, what's the likely cause of this patient's hypoglycemia?" Liu Banxia asked further.

"I think... I think it's due to pancreatic or endocrine reasons," Liu Yiqing said, hesitating slightly.

"Well, let's take a look after we open the abdomen. Xu Yino, pre-op prep; you're first assist. Liu Yiqing, second assist. Liang Xiaolin, Qing Kewa, you two observe," Liu Banxia instructed.

Xu Yino was very excited; this was a real first assist role. Although she had been first assist a few days ago when Liu Banxia performed surgery, today's emergency patient felt different.

Layer by layer, they opened the abdomen, exposing the entire abdominal cavity.

"A small amount of bleeding and exudate is visible in the abdominal cavity. Exploration reveals a duodenal perforation and a slight injury to the head of the pancreas. The probable cause is impact, consistent with the steering wheel imprint," Liu Banxia reported after his examination.

"We'll perform a duodenal perforation repair and partial pancreatectomy, and simultaneously check the pancreas for tumors. Once I've completed the ligations, prepare for irrigation and suction."

After saying this, Liu Banxia began operating.

This wasn't the first time he had performed an intestinal repair. This patient was quite fortunate; although injured with a duodenal perforation, his pancreatic injury wasn't severe.

If the pancreatic injury had also been severe, a pancreaticoduodenectomy would have been necessary—a major operation, the kind Wang Mingxing had performed. Liu Banxia himself might not have been able to handle it.

After irrigating the intestines and abdominal cavity, Liu Banxia proceeded directly to suturing. Whether there were tumors or cysts in the pancreas would be checked later.

Liu Banxia's suturing technique had improved, and this time, even he felt a deep sense of satisfaction as he worked. The perforation repair was completed in less than twenty minutes.

Even though Liang Xiaolin and the others had watched Liu Banxia suture countless times, it was always a pleasure to watch. He was not only fast but also exceptionally skilled.

"Dr. Liu, that's impressive suturing," Wu Mingyu, who was observing, commented.

"Thank you for the compliment, Dr. Wu. It's mainly because this perforation wasn't complicated," Liu Banxia replied. "Now, let's inspect the islets of Langerhans. I also suspect an issue there might have caused the patient's hypoglycemia."

"The current blood test results have ruled out drunk driving and drug-impaired driving. The most likely cause is a sudden loss of consciousness due to an underlying medical condition."

Liu Banxia inspected with extreme care, not missing the slightest detail. However, after the examination, he found nothing at all.