Directly added 28 life points to this medical skill.
"Damn it!"
Li Jingsheng expected to upgrade this medical skill, but unexpectedly it stopped at Pulmonary Medicine proficiency 99.4/100, and then got stuck.
It only consumed 27 life points in total.
He's already had an experience of such an upgrade failure before.
He knew that something was definitely dragging this medical skill down.
Spending a whole 27 precious life points and failing to upgrade was heart-wrenching!
Although the life points didn't run away after being added, and the proficiency needed to reach the next level decreased from 27.6 to 0.6, the failure still made him very frustrated.
The main issue now is not being wealthy, and every life point has to be used judiciously.
Wasting 27 points like this, if used to upgrade entry-level medical skills, could have at least upgraded two skills.
General Surgery Diagnosis and Cardiovascular Medicine Diagnosis are both at entry level, and he couldn't even bear to 'spend money' to upgrade them.
Although frustrated, he must now calm his mind and first handle the patient in front of him.
There's not even time to explore the specific reason for the upgrade failure now.
At this moment, the patient was clutching her chest, coughing violently, her face flushed from coughing.
As she spat into the trash can, Li Jingsheng observed closely.
It was white and sticky phlegm.
Spitting white sticky phlegm, pus is a sign of a cold constitution.
Could it be a cold?
Colds are divided into wind-heat and wind-cold, and the medication is completely different for each type.
Some people find that taking cold medicine has no effect on their cold symptoms.
It might even worsen the symptoms.
Could it be because the cold medicine taken was 'going in the wrong direction'?
Clearly a wind-heat cold, yet insisting on taking medicine for a wind-cold, isn't that foolish?
To conclude it's a wind-cold based on fever, cough, and white sticky phlegm alone would be too hasty.
For treating other diseases, Li Jingsheng might have limited experience.
But having run his clinic for over nine months, the most common disease he encountered was the common cold.
He felt that the symptoms of this female patient were slightly different from a cold.
Moreover, her complexion and symptoms differed from a typical cold.
This keen diagnostic ability can only be developed by frequently interacting with cold patients and accumulating rich experience.
If it's not a cold, then what could it be?
Unfortunately, his Pulmonary Medicine diagnosis upgrade got stuck, otherwise, he should have been able to easily diagnose the cause and type of disease.
"Let me listen to your lung sounds again!"
Li Jingsheng said to the patient.
"Didn't you do that just now?"
This time, the patient was somewhat unwilling.
Being examined by a male doctor with a cold probe on her chest was already slightly off-putting.
For the sake of treatment, she tolerated the first time.
Now with Li Jingsheng wanting to listen again, she couldn't help but question the male doctor's intentions.
"When I listened last time, I heard scattered dry and wet rales. After you coughed up the lung phlegm, it possibly changed, which is very important for diagnosing the cause. So it needs to be auscultated again, maybe two or three more times."
Li Jingsheng patiently explained to her.
"If you feel offended by the auscultation, you can hold the probe yourself, and I will guide you on where to place it while I handle the auscultation."
The female patient was of just above-average appearance.
Her temperament was fairly decent.
She retained some charm!
But to imply that Li Jingsheng had any impure thoughts about her would simply be insulting him as a doctor.
"Just place it on the chest as you did just now?"
"Yes! But during auscultation, the lung sounds might change locations. If I find anything new, I'll instruct you to move the probe."
"Alright."
She directly took the stethoscope probe and placed it on her chest.
Then, under Li Jingsheng's guidance, she slowly moved it around.
Auscultating lung sounds and heart sounds for adult women is indeed quite cumbersome. For many women, the thick layer of breast tissue can seriously hinder auscultation.
"There really are changes, after coughing and expelling phlegm, the dry and wet rales in both lungs are gone."
Li Jingsheng said somewhat excitedly.
For doctors, every new diagnostic finding during the assessment of a patient is a cause for great joy.
Because it means they are a step closer to identifying the cause of the illness.
The patient also realized that this young male doctor was genuinely serious about diagnosing her illness, without any ulterior motives.
Her expression softened considerably.
"Have you figured out what illness it is?"
She asked with some anticipation.
"Not yet, but there's been a lot of progress. Did you do anything before you started coughing yesterday?"
"No, just the usual stuff like watering flowers, pruning leaves, and reading. Started coughing during dinner, so I skipped the evening square dance..."
Nine out of ten elder women dance.
Who knows where square dancing gets its massive charm from?
Li Jingsheng obtained an important piece of information from her account.
"Coughing, phlegm production, and it's white sticky phlegm, accompanied by acute fever. Tonsillitis is basically ruled out. The possibility of infection in the upper respiratory tract is minimal. The lungs have a good defense system, making infection and pneumonia very unlikely in such a short period. That leaves the bronchi and trachea."
His eyes gradually brightened.
The threads were slowly clearing up, and the fog was being peeled away.
"Exposure to flowers and plants before onset could very likely cause allergic bronchial and tracheal inflammation... Yes, that's probably it."
With a preliminary diagnosis result, Li Jingsheng decided to perform an examination for the patient's safety.
He couldn't screen for viral infections here, nor check viral antibodies, mycoplasma, or chlamydia antibodies.
This is also the limitation of a small clinic.
However, he had an X-ray equipment, which could provide a chest X-ray for the patient to assess lung condition.
"Your condition requires a chest X-ray to see if the lungs are infected. Our Sunshine Clinic is cheaper than hospitals, charging 100 yuan per session. What do you think?"
Li Jingsheng asked the patient.
"Will a scan guarantee the detection of the cause?"
The patient's trust in such small clinics was not high.
100 yuan wasn't a small amount.
Women haggle for half a day to buy vegetables for two yuan; cosmetics and clothing are probably the easiest ways to earn their money.
"No doctor can guarantee finding the cause with an examination, no matter which hospital you visit. However, I can responsibly say that making this decision was after careful consideration and a certain direction in diagnosis. If it's a lung infection, I'll immediately advise you to seek treatment at a major hospital to avoid delays. But if a lung infection is ruled out, we can basically identify the cause, and I can treat it here, saving you the trouble of going to a big hospital. It can save a lot of time, allowing you to rest at home after treatment, and cut down on considerable medical expenses."
Li Jingsheng spoke with utmost transparency.
And every sentence was from the patient's interest perspective.
This undoubtedly gained the patient's trust and goodwill significantly.
"Alright then, take a scan for me to check first!"
The patient agreed.
Li Jingsheng led her into the medical technology room, which really only had a second-hand X-ray frequency machine and a Doppler ultrasound device.
It's not a color ultrasound, just a regular B-ultrasound.
A small clinic can't compare with the hospital's resources.
Hospitals have funding allocations from superior authorities and official support; a small clinic relies solely on itself.
"Sister Tang, has the infusion on the other side been handled? This lady needs an X-ray. Could you come over to help me?"
For this scan, Li Jingsheng could actually manage it alone.
However, since the patient seemed sensitive to male doctors, it's prudent to have Tang Ping assist him.
If the patient accused him of indecency, he couldn't clear his name even with ten mouths.
During the chest X-ray, the patient doesn't need to remove clothing but should avoid overly thick clothes and obstructions like metal ornaments.
Due to this X-ray machine's low clarity, Li Jingsheng exerted great effort to discern the lung patterns.
They were somewhat coarser.
Other than that, there weren't significant issues.
When there's money, a high-definition X-ray machine is a must-purchase.
Every time he uses this device, it gives him a headache.
Since the lungs only have slight coarsening in the lung pattern, it's essentially certain it's bronchial and tracheal inflammation.
The gold standard for diagnosing bronchitis is sputum smear and bacterial culture.
Chest imaging can also play a certain diagnostic role.
In most cases, it's necessary to combine blood profiles for a comprehensive diagnosis.
Li Jingsheng doesn't have these conditions but has to tackle this patient, relying only on experience, skill, and a bit of luck.
"What kind of flowers did you water yesterday?"
"I have lots of flowers! Roses, cacti..."
Mid-sentence, she had another violent cough.
After she finished coughing, Li Jingsheng directly asked, "Which of these flowers are ones you haven't grown before?"
"Those two lilies are ones I've never grown before. It's the first time, and I didn't expect them to bloom yesterday, with exceptionally large flowers."
Talking about growing flowers is a topic full of interest for her.
It's what she's most passionate about.
Li Jingsheng had already diagnosed.
"Your sudden coughing, fever, and white sticky phlegm this time are likely due to an allergy to lily pollen, causing bronchial and tracheal inflammation. I'll administer treatment first, though I suggest wearing a mask if you want to admire those lilies again."
The female patient had a face full of disbelief.
"Pollen can cause allergies too! I smelled other flowers without issues!"
"It's related to your constitution. You're not allergic to other pollen but allergic to lily pollen. This phenomenon is very common in clinical practice. I see you quite enjoy gardening, which is indeed a good thing, good for cultivating emotions and easing the mood, and also keeping one physically active. You don't need to abandon it due to this; just try to avoid lilies."
Li Jingsheng smiled and complimented her a couple of times.
Her planting behavior received affirmation, and she was pleased.
A smile appeared on her face.
"Alright, thank you, doctor. May I know your name?"
"My last name is Li, no need for formality!"
"Dr. Li! Honestly, I rarely visit small clinics when sick, and today, hearing Sister Hu praise your excellent results, saying you're considerate of patients, led me here. Experiencing it myself, I'm quite satisfied with the service. Now it's up to the treatment effect. If it's effective, I'll certainly recommend your clinic to others."
The female patient preliminarily accepted Sunshine Clinic's service attitude and medical ethics.
Now it depends on the efficacy.
The core is the efficacy.
As long as the efficacy is good, the patient will be satisfied.