The Enhanced Doctor

Last night was genuinely quiet. There wasn't even a single intoxicated patient. The gloomy weather from yesterday had cleared up by morning.

I checked my phone; Qiaoqiao still hadn't replied. I sent her another message: "Hurry up and get your car. If it gets scratched, even selling me wouldn't cover the damages."

"Wait, I'm busy."

Qiaoqiao replied quickly this time, attaching a short video. Tang Dou's tail was wagging like a pinwheel as he pranced ahead of Qiaoqiao on their walk.

Picturing Tang Dou dashing about freely with Qiaoqiao chasing frantically after him seemed quite amusing.

I decided not to disturb her. Tang Dou, though well-behaved at home, considered walks pure playtime and needed to run to his heart's content. If I kept messaging her now, Qiaoqiao might just let Tang Dou off the leash, and then she'd probably storm the hospital to confront me.

After breakfast, I delivered the report I wrote yesterday to Sun Changhe, the Chief Director's assistant. An assistant to the Chief Director is a truly busy person.

Once back in the emergency department, I made the most of my time by reading.

My conversation with Zhou Shuwen last night had clarified my future path. However, earning Honor Points wasn't easy, so I had to utilize every moment.

"President Liu, some intoxicated patients have arrived," Wang Chao called out.

Looking up, I saw a group of about ten people stumbling in, supporting each other. I checked the time; it wasn't even nine in the morning. These young men have some serious stamina!

"Everyone, prepare for a busy one. Get the spare basins and buckets ready. We're in for a long haul," Liu Banxia instructed, somewhat helplessly.

"Why? And they're being quite unreasonable, drinking so early in the morning, aren't they?" Liang Xiaolin asked curiously.

"Isn't it the start of the academic year? The new students haven't arrived yet. Judging by their appearance, they must be students who just finished their military training. Having finished their tough training, they're free to let loose a bit," Liu Banxia explained.

"They're all young people; when they drink, they go all out. Who knows what time they finished drinking? Hangovers are rough, and they probably came to the hospital fearing something serious. Still, they're not too bad. At least they're educated and sensible enough to seek help."

Liang Xiaolin rolled her eyes at his sarcastic tone. This kind of scene is probably unique to the emergency department, she thought. And judging by this group, their drinking session last night must have gone on for quite some time.

However, this group was much easier to handle than those who were completely inebriated. They merely felt unwell from their hangovers. Unlike other intoxicated patients, they weren't vomiting everywhere.

A few, however, required intravenous drips, as they showed mild symptoms of alcohol poisoning. Young people just don't know their limits.

"Banxia, the quality of our recent medical consumables seems to have deteriorated, especially the disposable infusion sets. The craftsmanship is clearly not as good as before," Wang Ying said as she approached.

I took the infusion set from her and inspected it. The plastic outer packaging does seem thinner, and the roller clamp looks a bit rough.

"Make a note of it for now. I'll raise the issue with the hospital administration later. Aren't these consumables and gloves also supplied by the Dazheng Group?" I asked.

"Yes, they were always fine before. This batch just arrived. Look at this packaging—it can tear if you're not careful handling it," Wang Ying said.

"I just did a quick count; three in this box are already damaged and unusable. The needles themselves are fine, but the tubing is too flimsy."

"Alright, I'll report it. We've had many patients needing IV drips lately. Many new students aren't used to the local environment and end up needing infusions," I nodded.

"Doctor! Doctor! My classmate fainted!" someone yelled from the infusion area nearby.

I hurried over. "Zhou Qian, connect the monitor. Lower the head of the bed so the patient is lying flat."

Then, I used a penlight to check the patient's pupillary response. That's somewhat reassuring; no major issues there, I thought. I carefully checked his pulse and breathing, auscultated his heart, and frowned slightly.

Once he was laid flat, his breathing gradually stabilized, and his pulse became stronger. The syncope seems to be caused by hypotension.

"Dr. Liu, the patient's blood pressure is 70/90, heart rate is 100," Zhou Qian reported, having just connected the monitor.

I nodded and picked up the medical chart hanging at the head of the bed.

The patient was admitted with symptoms of abdominal pain, diarrhea, and diaphoresis. At that time, his blood pressure was 90/120, and his temperature was 38.3 degrees Celsius. No known past medical history or allergies.

He had moist rales in his lungs and a dry cough. Blood tests showed a slightly elevated white blood cell count. Diagnosis: pneumonia. Currently receiving azithromycin. The admitting physician was Qi Wentai.

"What happened to the patient?" Qi Wentai asked, walking over.

"The patient just fainted. I suspect it was caused by hypotension. His blood pressure now is much lower than when he was admitted. Did you check his electrolytes?" I asked.

Qi Wentai shook his head. "He had diarrhea last night, but it stopped after he took some loperamide. He slept with the air conditioning on and woke up freezing. That's why I diagnosed pneumonia."

"Zhou Qian, run another complete metabolic panel, stat. Send me the results directly. This hypotension is definitely abnormal," Liu Banxia said.

"Doctor, is he okay?" the young man accompanying the patient asked.

"We'll have to see, but he should wake up soon. Does he have any other symptoms? When did he start feeling unwell?" Liu Banxia asked.

"When I woke up this morning, I found him lying on the sofa. He was a bit feverish then, so I brought him to the hospital. Other discomfort… I don't think so," the young man said.

"Let's wait for the latest lab results. He's a well-built young man; this blood pressure is quite abnormal for him," Liu Banxia said.

"He's always been very fit. We're both from the sports college; we exercise and train a lot," the young man said.

It's unlikely the azithromycin caused the hypotension, Liu Banxia thought, glancing at the nearly empty IV bag. Although it's a possible side effect, he's been on the drip for a while. If there were a reaction, it would have happened much sooner.

"Doctor, he's not going to… not wake up, is he?" the young man asked worriedly.

"No, he will. Although his vital signs are a bit low right now, they're stable. We'll wait for the new blood test results to see," Liu Banxia reassured him.

The patient's condition is stable for now, so no emergency measures are needed. The fainting was likely due to hypotension, and since his blood pressure is now manageable, he should regain consciousness on his own.

"Why didn't you consider a urinalysis for the patient?" Liu Banxia asked after they stepped aside.

"The patient's signs and symptoms clearly pointed to pneumonia," Qi Wentai responded.

Liu Banxia said nothing more. It wasn't entirely Qi Wentai's fault. Indeed, among the manifested symptoms, everything except the abdominal pain and diarrhea was consistent with pneumonia. But hypotension, along with abdominal pain and diarrhea... that's definitely problematic.

「DING! Mission Alert: Patient with Hypotensive Syncope. Open Mission: Patient experienced sudden hypotensive syncope post-IV infusion. Host must determine the etiology. Reward contingent on diagnostic accuracy.」

"You can attend to other patients. I'll take over this one," Liu Banxia said after a moment's consideration.

Qi Wentai glanced at him but said nothing.

This was the second time Liu Banxia had taken over one of his patients, and it irked Qi Wentai. He hadn't thought there was anything wrong with his earlier admission either. If a nurse couldn't do her job properly, what did that have to do with him, a surgeon? Still, Liu Banxia was the chief resident, and the patient *had* just fainted. As long as it wasn't caused by the infusion, it wasn't his, Qi Wentai's, problem.

"Are you both students from the sports college? What year are you?" Liu Banxia asked, approaching them again.

"We'll be third-years when the semester starts. We both came back two days early to clean our apartment. He just got back yesterday and was fine then," the young man said.

"Doctor, should we contact the college now? He isn't in any danger, is he? We were just talking a moment ago, how could he just faint like that and not wake up?"

"Try to stay calm. Once the blood test results are out, we'll have a clearer idea of what's going on," Liu Banxia comforted him.

"He was fine when he returned yesterday. What did you two eat last night? His symptoms are somewhat complex. I'm wondering if the fever is due to another cause."

"We didn't eat anything unusual. We just went to the noodle place near our apartment and had two bowls of noodles each, some fried peanuts, smashed cucumbers, and a beer," the young man replied.

"Then, later that night, we both got a bit hungry and had some fruit and snacks together. He was perfectly fine then. This morning, I found him lying on the sofa, saying he had diarrhea."

Liu Banxia nodded. It doesn't seem like food poisoning; otherwise, this young man would probably be sick too, he mused. But I have to wait for the latest blood test results. Can't rule anything out yet. I really did think he might have eaten something bad at first.

After waiting a little longer, the patient still hadn't woken up, but Liu Banxia's phone rang.

"Hello, this is Liu Banxia," he answered.

"Dr. Liu, it's Zhou Qian. The patient's potassium is 5.6 mmol/L, and his blood pH is 7.1," Zhou Qian reported urgently.

"Damn it! 250 mL of 5% sodium bicarbonate, stat!"

Liu Banxia couldn't help but swear.

He hadn't anticipated signs of renal failure and acidosis. Thank goodness they caught it in time; otherwise, this young man would have died. Even now, he couldn't be sure of the outcome, as the underlying cause was still unknown.