029 Difficult Psychological Barriers to Overcome

The rest of the time passed in a daze, his mind a bit muddled.

"Ah, Brother Yong, so it's your turn to hold down the fort in the ER today." After grabbing a quick bite at the cafeteria, Liu Banxia returned and saw Chen Jianyong, the attending physician from the Department of General Surgery.

"You did well today, kid. That suturing was truly beautiful," Chen Jianyong said with a smile.

"Brother Yong, don't praise me too much, or I'll definitely get arrogant," Liu Banxia replied playfully.

"That was really a boost today. Otherwise, people would always say us residents are just slacking off," said Wang Chao, the resident physician training under Chen Jianyong.

"How are things with you? Shouldn't be a problem for you to secure a position here this year, right?" Liu Banxia asked Wang Chao.

"Should be more or less fine, but nothing's certain until the very end. Boss, Shoutian, cover for me. I'm going to buy some fruit," Wang Chao said and then ran out.

"Shouldn't you be putting in some effort too, kid?" Chen Jianyong asked Liu Banxia.

"Brother Yong, it's not that I'm not trying, but the 'enemy' is too cunning. It's up to luck, I guess. After all, my qualifications aren't up to par yet," Liu Banxia said with a wry smile.

Chen Jianyong patted his shoulder. "Are you doing okay tonight? Shi Lei is quite worried about you. He's reminded me several times to keep an eye on you."

"I'm fine, Brother Yong. It is what it is. When patients come, I can't just stand by and watch," Liu Banxia said, a bit embarrassed.

He was deeply moved. Shi Lei was a good boss; he had decided to follow him for life.

Wang Chao was quick. In no time, he returned with two large bags of fruit, much to the delight of the ER nurses.

"Dr. Chen, a 36-year-old male patient with abdominal pain has arrived," Xu Dan said, walking over as they were chatting.

"Wang Chao, you take this patient. We'll observe," Chen Jianyong said.

Wang Chao nodded eagerly and hurried over. Liu Banxia didn't mind. Chen Jianyong was the attending physician on duty today, so it was natural to prioritize the resident he was supervising.

Arriving at the bedside, they saw the man curled up on the bed, clutching his abdomen and groaning incessantly. His wife was accompanying him.

"Hello, what are your symptoms?" Wang Chao asked.

"I have a stomachache. It used to be intermittent, but it got much worse after eating today. Lately, I haven't had much of an appetite, and I sometimes feel bloated. I also feel nauseous at times; I've vomited twice between yesterday and today," the patient replied.

"Please lie down properly, let me take a look," Wang Chao said, a hint of excitement in his eyes.

Working a shift in the ER had its perks. One often encountered appendicitis patients, which meant a chance to participate in surgery.

After a careful percussion, Wang Chao frowned. "Dr. Chen, the patient has upper abdominal pain. There's no rebound tenderness in the right lower quadrant, ruling out appendicitis. However, I think I just felt a hard mass in the upper abdomen. We could do an ultrasound for a preliminary diagnosis of gastric calculus."

Chen Jianyong smiled and nodded, then had the patient drink water and arranged for a gastric ultrasound.

Looking at the ultrasound display, although it wasn't particularly clear, it startled Liu Banxia. In the stomach, there were two egg-sized hyperechoic masses, along with some smaller arc-shaped and short linear echoes.

Wang Chao's assessment was very accurate: these were gastric calculi, and multiple ones at that.

"What are your usual eating habits? Do you like to eat persimmons, black dates, hawthorn, those kinds of foods? Hmm... do you?" Wang Chao asked after marking the images.

"I used to love eating persimmons; we had a persimmon tree at home. I've been in Binhai for over four years now and haven't eaten them much since," the patient said.

"You have two large stomach stones in your stomach, along with some smaller ones. They were likely caused by the persimmons you used to eat frequently. Given the size of the stones, I recommend you be admitted to the hospital for surgery to remove them," Wang Chao said after a moment's thought.

"There are two methods. One is lithotripsy via gastroscopy. The other is to make an incision in your stomach to remove the stones. Because the stones in your stomach are truly too large, extracorporeal shock wave lithotripsy isn't an option. Even with medication, it would be very difficult to dissolve them."

"Doctor, can it be done now? I'm in so much pain," the patient asked.

"Let's wait until tomorrow. If we operate now, we'd have to make an incision in your stomach, which would be very traumatic to your body. We'll observe you overnight; have your family handle the admission procedures. Start fasting now. Tomorrow, we'll perform a gastroscopy to check if non-invasive lithotripsy is possible. That would be best," Wang Chao said with a reassuring smile.

DING! Acquired 30 experience points and 40 skill proficiency points in Diagnostics.

Looking at the system prompt, Liu Banxia felt quite pleased. Could this be considered leeching EXP?

The patient nodded. Although he was in a lot of pain, it would be a great relief if surgery could be avoided.

"The year before last, I treated a female patient who liked to eat hair. Nearly a third of her stomach was filled with ingested hair. We had no choice but to operate to remove it," Chen Jianyong said after the patient left.

"Hehe, I almost asked about that. But when I saw the patient had a buzz cut, I held back," Wang Chao said, a bit sheepishly.

"Actually, it wouldn't have mattered if you'd asked. Many patients with gastric calculi also have pica," Chen Jianyong replied nonchalantly.

"Dr. Chen, two car accident victims are about to arrive! One is pregnant, and the paramedics suspect internal bleeding," Shen Lin rushed over, saying.

"Prepare to receive them," Chen Jianyong said gravely.

After about three minutes, the ER doors burst open, and paramedics rushed in with stretchers.

"Patient is comatose, blunt force trauma to the head, chest, and abdomen. BP was very low when extricated from the vehicle. Stabilized to 90/60 after placing her in the left lateral position and administering fluids," a paramedic reported.

"Resuscitation Room One! Liu Banxia, secure the airway, perform a full trauma survey. Cross-match blood, prepare two units of plasma," Chen Jianyong ordered.

"Ah... Dr. Chen, there's also a patient with a head laceration. I'll take that one," Liu Banxia said, already moving towards the next patient being wheeled in.

Chen Jianyong frowned. He had hoped to use this patient to help Liu Banxia overcome his psychological block. It seemed the previous emergency patient had indeed affected him greatly, causing him to shrink back at the sight of this one. There was no time to dwell on it. He led Wang Chao into Resuscitation Room One with the patient.

Liu Banxia took a deep breath. Seeing the patient on the stretcher, he felt as if he were reliving the day before yesterday; his palms began to sweat.

"Doctor, is that young woman going to be alright? Sigh... why do these things always happen to me?" the man in his fifties, clutching a gauze pad to his head, asked with a troubled expression.

"You hit your head? Let me take a look," Liu Banxia said.

Removing the gauze, Liu Banxia saw an approximately five-centimeter-long laceration on the left side of the man's head, still oozing blood.

"I'll treat your wound first, then we'll get a head CT scan. Are you experiencing any other discomfort?" Liu Banxia asked while leading the patient to a treatment room.

"Nothing else significant. I'm a ride-share driver. I'm not badly hurt, but the passenger side took a hard hit. Damn those drivers with their high beams!" the patient grumbled.