Chapter 264: Physical Examination

Early in the morning, Ling Ran, who had only performed one surgery before that, languidly performed a ward round. He obtained four Sincere Gratitude treasure chests during that wardroom.

Ling Ran hesitated a little when he looked at the sixteen Basic Treasure Chests which he had accumulated from the system. Theoretically speaking, the number sixteen was the fourth power of the number two, and could be obtained by performing a 2x2x2x2 calculation. And in the binary system, sixteen was written as 10,000. It was the epitome of a whole number.

So, should he open the treasure chests, or should he open the treasure chests?

The previous time he opened multiple Basic Treasure Chests at the same time, he obtained two skills at once.

Even though the heavy reinforcing suture technique and intradermal suture technique overlapped quite a bit, they could be seen as a group of related skills. When he thought about it this way, Ling Ran found it more useful if the Basic Treasure Chests gave him two skills at the same time.

Hence, he had most definitely not expected to obtain two skills at the same time if he opened sixteen Basic Treasure Chests at once.

Ling Ran was absorbed in his thoughts and quickly made a decision. He said, “Since no surgery is arranged for us yet, shall we perform another round of physical examinations?”

Lu Wenbin naturally did not mind, but he asked curiously, “Did we miss something just now?”

“How is it even possible to catch everything in one round?” Ling Ran twitched his lips.

Lu Wenbin had no way to object.

From a doctor’s perspective, it would never be enough no matter how many rounds of physical examination they performed. The human body was much more complicated than what human beings could fathom. Take, for example, the simplest procedure of all: the measuring of blood pressure. Different methods of measuring blood pressure would bring about different results, and a person’s blood pressure on the left arm would be different compared to the blood pressure on his right arm. Blood pressure also differed according to the position the patient was in and the time of the day the blood pressure was taken. Hence, they did not ask for high accuracy in blood pressure indices. However, similar situations would still be found for tests that required high accuracy.

Even when it came to MRI scans, the reference material for judging whether a patient’s anatomical structure was normal only consisted of around a hundred, or at most around four hundred healthy people’s scans.

If it were not for the fact that various scans produced radiation which was harmful to the human body, or that procedures such as the drawing of blood led to damage to the human body, a patient’s daily examination would become much more complicated.

The physical examination was considered a very economical examination method. It was just that the frequency at which it was performed was slowly reducing.

Patients always wanted answers that were certain. It was the same when it came to medical lawsuits. And it was very hard for physical examinations to provide certain answers.

However, the functionalities of physical examination for preliminary screening purposes still could not be ignored.

Ling Ran made a ward round again and performed physical examinations on the patients, one by one.

Lu Wenbin followed behind Ling Ran, and he was so busy that his head was spinning. He could not help but say with a sigh, “I have heard stories about how all the doctors in the 1960s and 1970s perform ward rounds twice every day. Never have I thought that something like this would happen at this day and age.”

“The first round is for a rough check-up to fulfill the patients’ basic needs. The second round is for us to perform a meticulous examination and solve the patients’ problems based on their exact needs. There’s nothing bad about this.” Ling Ran paused for a moment and said, “It’s too bad that I’m not a doctor of internal medicine.”

The indications made by surgeons and internists were completely different, and their abilities to handle various problems were also different.

Take diarrhea as an example. It might be a small problem that the patient could handle by himself if he were at home. But in the hospital, when a surgeon heard that the patient experienced diarrhea, he would not be able to handle it as well as internists.

There were way too many things that had to be taken into consideration, to the point that surgeons could usually only get rid of the patients’ symptoms instead of getting to the root of the problem.

Surgeons would prefer to hear terms such as “cramps”.

Ling Ran could not simply prescribe medicine to patients either. Every now and then, when he discovered a problem during a physical examination, he could only arrange for the patient to undergo further checkup.

Lu Wenbin had not even grasped many of the surgical skills, and was still at the stage where he was climbing the roots of the skill tree. He felt as if his notebook was getting heavier and heavier, and he was worried about how this was going to make it harder for him to write the medical records of Ling Ran’s patients.

However, these were not the kind of things that you could tell a senior doctor, and you could only think about it in passing. Any senior doctor would definitely scold a junior doctor the moment he heard these words.

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As Lu Wenbin stared at his notebook, he could only say something that was pleasant to the ears. “Your physical examination skills are a lot better than many internists. You discovered quite a few problems only after performing one round of physical examinations.”

Ling Ran nodded with a hum and said, “Since we have no more vacant beds, we’ll examine the patients more. We can discharge those who are recovering quickly if they experience no other problems.”

Lu Wenbin chuckled. He knew that this was what was on Ling Ran’s mind.

As he made his ward round, Ling Ran received another Basic Treasure Chest courtesy of ‘Sincere Gratitude’ and arranged for two patients to be discharged. The ward round could be said to be a success. When they were done with the final ward, Lu Wenbin was already panting from fatigue and breathing in relief at the same time. However, Ling Ran stood there and showed no signs of wanting to leave. He then carefully examined the patient on Bed 52 again. He said after walking out to the corridor, “Could you ask the doctors from the Department of Hepatobiliary and Pancreatic Surgery to come and take a look?”

“Is there a problem?” Lu Wenbin’s expression changed a little.

As Ling Ran’s assistant, even though Lu Wenbin had participated in a few hundred operations, he was still a resident doctor. When he was in the wards, he was the doctor in charge of the beds. Hence, he was the one with the closest relationship with the patients. He not only understood the patient’s condition, but would also worry for them.

After all, he interacted with the patients on a daily basis. Over the past few weeks, not only had he heard what the name of Bed 52 patient’s dog was, but had also met her parents, relatives, distant relatives, and colleagues…

Ling Ran was not only an actual senior doctor, but also a senior surgeon. Hence, his main task was to carry out surgeries, and he knew way less about the patients compared to the doctors in charge.

This kind of arrangement was actually a natural development as a result of the hospital’s system.

China was not the only one affected. It was the same in countries such as Japan, Korea, India and other countries in Asia, countries in the European or American continent as well. Chief surgeons would always consciously detach themselves from the actual management of the patients.

This attitude could not only be attributed to their high workload, because the workload of internists was high, too, and excellent internists were usually highly involved in the management and the well-being of their patients.

In the end, it was the work nature of surgeons itself which made them unwilling to develop too much of a close relationship with patients and their family members.

Even though Ling Ran was not good at dealing with people, he understood how Lu Wenbin felt right now.

Hence, he deliberately gave careful consideration for a moment before saying, “The patient might have cholecystitis. An acute one. The patient experienced tenderness and rebound tenderness. Gallbladder tenderness was not too obvious yet, but she might be developing cholecystitis.

Acute cholecystitis might require surgery, but a physical examination alone was not enough to confirm that a patient had acute cholecystitis.

Lu Wenbin breathed a sigh of relief. For doctors, this kind of illness was not considered a serious one. It would be fine as long as prompt treatment was given.

After a short while, a doctor from the Department of Hepatobiliary and Pancreatic Surgery arrived.

The Department of Hepatobiliary and Pancreatic Surgery of Yun Hua Hospital was only of average standard. Of course, this was measured based on the standards of the departments in top-class tertiary grade A hospitals. When it came to illnesses such as acute cholecystitis, any attending physician who specialized in hepatobiliary and pancreatic surgery could treat it.

“Doctor Dan, Doctor Ling.” Lu Wenbin had met the doctor before, and he made a simple introduction.

Doctor Dan nodded a little. “Can I take a look at the patient’s medical record?”

Lu Wenbin passed the medical record he prepared beforehand to Doctor Dan, and the latter started reading it while standing in the corridor.

“Indices such as heart rate and blood pressure are a little high. It would be difficult to perform surgery under this condition.” Doctor Dan frowned when he saw the medical record Lu Wenbin gave him.

Lu Wenbin coughed a few times and said, “The physical examination was performed personally by Doctor Ling. Hence, these figures are considered normal.”

“You’re telling me that a blood pressure of one hundred and thirty in such a young person is normal? And a heart rate of ninety is a little too high, don’t you think so?” Doctor Dan was dissatisfied with Lu Wenbin’s answer.

Lu Wenbin looked around before saying, “Usually, when Doctor Ling personally carries out physical examinations, the blood pressure and heart rate of female patients—especially unmarried ones—would rise a little. You just have to subtract around fifteen to twenty from these figures, and you will come up with the actual figure.”

When Doctor Dan heard that, his spectacles almost fell off. He turned to glance at Ling Ran, who had his usual calm expression on his face, and looked at Lu Wenbin again, “You’re joking, right?”

Lu Wenbin looked upset. “Why would I make such a joke? Take a guess at how I knew that the figures would drop.”