System Came When the Doctor was Thirty

”But if it had ruptured... um, Dr. Lu, thank you so much...” The middle-aged man clasped Lu Cheng’s hands, his tone sincere.

”My daughter, she doesn’t listen to me. I had wanted her to study nursing at a vocational school first and then go to college...”

Lu Cheng said, ”Uncle, studying isn’t the only way out. They’re doing quite well now.”

Perhaps Liu Zhongping had laid out the facts clearly during this time, the middle-aged man sighed slightly, ”The things these young people are doing now, we don’t understand. Just feel that this money is unreliable.”

”Having a stable job, no matter what happens, at least there’s some security.”

”Of course, young people now have their own way of thinking.”

”Dr. Lu, really, thank you... this time I’ve also come to understand, as long as you’re alive, that’s enough in life.” The middle-aged man spoke self-reproachfully.

Just at this moment, some skill points flickered on Lu Cheng’s panel again.

[...Skill points increased by 12.]

Lu Cheng’s smile broadened further—

[Identifying ’ectopic pregnancy’ ahead of time, providing the patient with ample treatment time, reducing the patient’s pain and risk of blood loss, gained 7.6 skill points]

[In an unexpected way, untangling the knots for patients with ’depression’, ’anxiety disorder’, ’obsessive-compulsive disorder’, reducing the patient’s psychological struggle and torment time, gained 5.2 skill points]

[Helped a patient with mild ’anxiety disorder’ smooth over psychological fluctuations, gained 0.4 skill points]

The source of the skill points is unknown, but Lu Cheng guessed they might come from the girl, the girl’s father, and Liu Zhongping.

Lu Cheng watched the girl’s father walk away, slowly sorting out his thoughts—

The girl’s father should be a relatively traditional elder, who believes not having a formal job is unstable, hence he disapproves of Liu Zhongping.

As for Liu Zhongping, he lacks education and culture, but that doesn’t mean he lacks ability. Even if there’s an opportunity, he’s sure to seize it.

Under such circumstances, the girl’s father still disapproves of him, so it’s understandable that his heart feels unsettled.

Otherwise, with his current financial strength, he could have long since overpowered the father-in-law. A cash flow of a million, even in a prefecture-level city, is not considered poor...

As for Liu Zhongping’s girlfriend, it can be said she’s lucky in her own foolish way.

If she had a boyfriend like ’Yellow Hair’, her lifestyle would be completely different.

This kind of skill point gain is rare compared to conventional disease treatment. It doesn’t have a targeted approach, but once gained, the amount is quite substantial.

Just then, Tian Zhuang called, saying there was a patient with a hand laceration arriving at the emergency surgery clinic.

As soon as Lu Cheng heard the call, he quickly put away his thoughts, donned his mask, and left the doctor’s office heading to the emergency surgery clinic...

”Whether you have the surgery here or not doesn’t matter to me. I’m just telling you that this situation requires surgery, not that you must have surgery here.”

”You need to understand this fundamental point.”

”If you demand a higher quality surgery, and feel our skills here aren’t sufficient, you can completely go to the State!”

”Right? You want to be transferred, right?”

”Are you going to call a car yourself or how do you want to handle it?” Tian Zhuang was communicating with the patient, his tone cool.

After Tian Zhuang’s tone cooled, the father and son instead fell silent, exchanging glances.

The elderly man asked, ”Dr. Tian, how much would it cost if I went to the State Hospital for surgery?”

Tian Zhuang, unfazed, just shook his head, ”Specifically, I don’t know. I’m not from the State People’s Hospital, I can only tell you it would certainly be more expensive than here.”

After saying this, Tian Zhuang noticed Lu Cheng and said, ”Dr. Lu, this patient wants to transfer, you don’t have to come over.”

Upon hearing this, Lu Cheng nodded, stepping aside at the door, without going in to meet the patient.

Doctors don’t knock.

Since the patient had clearly refused, Lu Cheng couldn’t convince them otherwise.

The patient’s right to informed consent and informed refusal is equal.

Five minutes later, Lu Cheng received another message, Tian Zhuang said the patient decided to stay and have the surgery.

Lu Cheng could only go over to have a conversation, get signatures, and lead the patient to the operating room...

At three o’clock in the afternoon, after the surgery was perfectly completed, Lu Cheng returned to the doctor’s lounge to prepare post-op orders and surgery records.

Another person in a white coat in the doctor’s office stood up upon hearing, ”Are you Dr. Lu? The emergency doctor who identified the premonitory symptoms of an ectopic pregnancy for Xie Misu in our department?”

Lu Cheng, wearing surgical scrubs, gently rubbed his eyes, recognized Zhao Ruifang’s name badge, and smiled, ”Dr. Zhao, it was me who discovered it.”

”At the time, she was a family member of one of my patients who had an appendectomy. She was sitting by the bedside, yet Xie Misu was lying on the bed, which I found strange, so I just did a simple physical examination.”

Xie Misu is Liu Zhongping’s girlfriend’s name, and she is now in the gynecology ward.

Zhao Ruifang, being Xie Misu’s attending physician, couldn’t be the first to see her pre-admission records in the emergency department, but for safety’s sake, she still visited the emergency department.

With a mask on, Zhao Ruifang’s eyes appeared smallish, she wasn’t very old, and her voice was crisp, ”She didn’t rupture, the pain wasn’t very pronounced. How did you diagnose it?”

Zhao Ruifang’s tone was puzzled, leaning against the desk with a genuinely curious look, seeking to learn the details of Lu Cheng’s diagnosis.

”Just through physical examination!~” Lu Cheng replied.

Zhao Ruifang thought for a moment and then said, ”Usually, an ectopic pregnancy patient only shows the triad of cervical motion tenderness, rebound tenderness, and peritoneal irritation signs after it ruptures!~”

”The girl wasn’t in the prime reproductive age either.”

Seeing Lu Cheng’s slight frown, Zhao Ruifang quickly explained, ”Dr. Lu, don’t get me wrong, I didn’t mean to question you.”

”I’m just curious. In such circumstances, without ultrasound detecting the gestational sac, it’s hard to determine an ectopic pregnancy without asking the patient about her menstrual history.”

”Moreover, I would prioritize considering gastroenteritis or appendicitis since the warning pain of ectopic pregnancy isn’t that intense.”

The standard signs of a physical examination for ectopic pregnancy point to one thing: rupture and bleeding.

Rebound tenderness: Upon quickly lifting the hand, a patient reports pain indicating abdominal bleeding, as blood stimulates the peritoneum.

[Mobility dullness (+)], a sensitive indicator of intra-abdominal bleeding ≥500ml in percussion dullness zone shifting.

Lu Cheng calmly replied, ”Maybe I was just lucky or read some similar science materials somewhere, so I thought of it first, no great technique involved.”

Lu Cheng himself hadn’t paid much attention to this matter. Considering ectopic pregnancy in a grown woman wasn’t it something teachers routinely remind?

As for why he asked about her menstrual history firsthand, Lu Cheng couldn’t explain.

Perhaps during the examination, his physical examination skill level was high enough to give himself ’inspiration’ and indication unnoticed?

Now, with Zhao Ruifang bringing it up, if Lu Cheng analyzed it from a professional knowledge perspective, indeed, the girl’s pain shouldn’t have prioritized ectopic pregnancy.

”Oh!~”

Zhao Ruifang stood up straight, ”Thank you, Dr. Lu, today’s ectopic pregnancy was handled most smoothly in our department.”

”I thought you had some technique to accurately identify premonitory symptoms of ectopic pregnancy.”

”As you know, if the situation were too urgent, usually it’s the department head who handles it...” Zhao Ruifang finally explained the purpose of her visit.

The patient’s situation was still stable, but for ectopic pregnancies early detection calls for early treatment!

Zhao Ruifang hoped to encounter more ’warning patients’ to accumulate surgical experience for herself.

”No need to thank me, it was just sheer luck on my part, Dr. Zhao.”

After Lu Cheng finished speaking, he continued, ”I just finished the surgery here and have to issue some medical orders, Dr. Zhao, you have your own work?”

”Alright!~ Sorry to bother you, Dr. Lu.” Zhao Ruifang left the doctor’s office without further questions.