Practicing Medical Skills in a Small Clinic novel Chapter 40

Chapter 40: Chapter 40: An Old Man’s Love

Li Jingsheng really wanted to say, a thousand yuan red envelope is not too little, two thousand is not too much, our small clinic doesn’t have many rules. As long as the patient dares to give, I dare to accept.

But after thinking about it, better not.

Saying it would be too low.

If the patient’s illness is cured, and the patient is truly grateful, they will naturally give a big red envelope then.

It’s never been legally prohibited for medical staff to accept red envelopes.

This is a rule put forward by hospitals to enhance medical ethics and prevent doctors and nurses from exploiting patients, specifically as a self-regulating measure. Complaint calls are handled by departments like the hospital’s medical office and disciplinary inspection room.

It must be noted, accepting bribes and patients voluntarily giving red envelopes are two different concepts.

Bribery is illegal.

Receiving gifts from patients is not illegal, but it violates the hospital’s self-regulation rules.

Li Jingsheng is the boss himself, so even if he accepts a red envelope of a hundred thousand, it doesn’t matter.

That’s the benefit of being your own boss.

"Oh, I know, I know!" When the old man got angry, the old lady outside stopped making a sound.

If we’re talking about wisdom, surely men are stronger.

The old man writes Li Jingsheng a blank check to make sure Li Jingsheng takes extra care in treating him.

Also, winning over Li Jingsheng’s goodwill will make the costs more transparent.

The medications prescribed will be good.

With so many benefits, even if he actually gives a red envelope after getting better, it’s worth it.

Spending small money to get big things done refers to giving gifts.

In some less ethical hospitals, if you don’t give the chief surgeon a red envelope, the surgery is handed off to junior, resident doctors, as long as there’s no safety incident, it’s okay. As for the surgical effect, being used as a guinea pig by a group of novices, it’s easy to imagine.

If there are any leftovers, one has to suffer for decades.

If you don’t give the anesthetist a red envelope, you might wake up from pain halfway through the surgery...

These are true incidents that have occurred in certain hospitals with poor ethics.

Patients have to grease palms everywhere for a surgery.

The old man has simple wisdom, whereas his wife seems smart but loses greatly for petty gains, lacking true wisdom.

Li Jingsheng led the old man to the exam room for an ultrasound, revealing the sinus tract to be shorter than expected.

And particularly thin.

Without knowing there was a hidden sinus tract here, even an ultrasound might not detect it.

Then an X-ray was done.

Every time doing an X-ray, he wanted to smash the machine.

The clarity was truly too poor.

After much effort, it finally became clear.

Compared and verified the ultrasound results.

Indeed, the location of the sinus tract found in both tests matched in length.

X-rays pass through tissues’ thickness and density, and are absorbed by tissues, reducing the amount of radiation reaching the fluorescent screen, generating black-and-white contrast through radiation changes.

Clinically, it’s the most affordable and effective for checking fractures.

Ultrasound produces reflecting waves within the body via sound waves, forming images through electronic computer energy conversions afterward.

Its advantage is obtaining sectional organ images, allowing direct observation of organ shapes, prompting objective data like gallbladder, bile duct diameter, wall thickness, and pathology size based on automatic measurement results.

Its disadvantage is difficulty penetrating deeper into bone and air, making it hard to detect air-filled organs like lungs and gastrointestinal, also less effective in adult brain diagnoses. Repeated reflections during imaging can cause false images, even misdiagnosis.

Li Jingsheng uses X-rays and ultrasound simultaneously to avoid misdiagnosis.

Obtain more accurate sinus tract data.

Including its length, width, position, depth, etc.

"Dr. Li, did you find out?"

"Basically yes, it’s a hidden sinus tract causing a superficial back abscess. Without eliminating this sinus tract, the abscess won’t heal and will keep recurring. Also, due to prolonged use of anti-inflammatory drugs, you’ve developed some drug resistance. I recommend immediately dealing with this hidden sinus tract and then perform debridement in the abscess cavity, should cure it completely."

Li Jingsheng told him.

"Can you do it here?"

Clearly still a bit unsure about the small clinic.

"Yes."

Li Jingsheng’s answer was firm.

At times like this, it’s essential to give the patient confidence. If you’re not confident, why would the patient trust you?

"Does it need surgery?"

"Definitely!"

"Is the incision deep?"

"The sinus tract is superficial, and based on my surgical experience and clinical anatomy, I’m sure there’s no major blood vessels or important nerves here, risks are present but very low. Honestly, if it were a major or high-risk surgery, I wouldn’t dare take it either."

Li Jingsheng knew what the patient was worried about.

Nothing but safety.

How to answer to dispel the patient’s concerns, he’s long trained for that.

Don’t assume that surgeries in major hospitals are easy to convince family and patients.

They too have various doubts, usually handled by interns and ward doctors to persuade. If the chief surgeon is to handle such trivial matters, they might as well quit.

The chief surgeon is usually at least an associate chief physician, shadow rarely even visible due to busyness.

Only Monday or Friday’s chief rounds may spot them.

Li Jingsheng honed his persuasion when managing the ward. Interns aren’t heavy enough, discussions typically led by ward doctors with families and patients.

Once discussions are mature, then invite the chief surgeon for a formality.

If it’s spinal or general anesthesia, anesthetists also approach families. Primarily to inform them of risks and obtain signatures.

"Does this require staying here for treatment?"

"No need. But post-surgery, your wound mustn’t touch water and requires daily check-ups and dressing changes on time."

From the patient’s questions, Li Jingsheng knew it was basically settled.

"Let me discuss with my wife and get back to you."

The old man stood up and left the exam room.

"Alright."

Li Jingsheng certainly wouldn’t force the patient to do surgery here.

But he really hoped to secure the business.

The old man discussed with the old lady for a good half an hour.

Surprisingly, the old lady didn’t object this time.

She promptly paid the 2000 yuan.

Some old couples truly have money, I must say.

After receiving the payment, Li Jingsheng issued a receipt and then stamped it with the clinic’s finance seal.

"Please rest outside; I’ll take the old man into the treatment room for the surgery. Afterward, during the IV, you can be there to accompany him," Li Jingsheng told the old lady.

"Mm-hmm! Please take care."

The old lady sat on the sofa outside the treatment room. Li Jingsheng even poured her a cup of water.

Tang Ping had to do the pre-surgery preparations now and had no time to attend to the patient’s family.

She brought the old man into the treatment room, having disinfected and laid out the drapes.

"Are you comfortable lying down?"

"Yes."

The old man lay down on the bed in the treatment room.

The small clinic’s conditions were too simple, and they hadn’t performed surgical procedures before. At most, they cleaned wounds, sutured, and bandaged.

Though a small surgery, this was a true surgical procedure.

Li Jingsheng was somewhat nervous, but more excited and expectant.

The skills like skin incision, superficial debridement, multiple suturings, knotting, and hemostasis were all at a proficient level.

Finally, he had an opportunity to practice these skills.

There were certainly risks in performing this surgery; it wasn’t as easy as he told the patient.

The sinus tract was about 2cm deep, considered superficial.

Its length was 7cm, which was quite long.

To remove the tract, the wound would necessarily be longer than the tract.

After initial disinfection of the patient’s back wound, Li Jingsheng prepared to wash his hands, then proceed with sterile management as rigorously as in a large hospital.

The old lady was waving at him from outside the door.

Li Jingsheng went over and opened the door.

Could it be that the old lady was scared of the risks and decided against the surgery for the old man?

"Dr. Li, could you step outside for a moment? I have a few words to say to you."

Li Jingsheng quietly wondered; they were already set to go, please don’t stop at the last minute!

After stepping outside, the old lady pulled him to the side, secretly slipped a wad of cash into his hand.

"A small token, please focus on my old husband’s surgery and ensure his safety."

The cash in hand exceeded a thousand yuan.

A thick stack.

Li Jingsheng was genuinely shocked. Not long ago, in the examination room, the old man casually mentioned giving Li Jingsheng a big red envelope once cured, and the old lady anxiously knocked on the door.

Yet at this moment, before the surgery, she called Li Jingsheng out and secretly gave him a red envelope.

And it was at least a thousand yuan.

She must love her old man deep into her bones to do such a thing!