"Acute Intermittent Porphyria, or AIP, is an autosomal dominant genetic disorder. The onset age is typically between 20 and 40. It's caused by a deficiency of uroporphyrinogen synthase in the liver. This leads to lower-than-normal levels of uroporphyrinogen, which in turn causes a disorder in heme synthesis... This ultimately leads to an increase of porphobilinogen in the urine, which converts to uroporphyrin and porphobilin when exposed to light, turning the urine red."
"Furthermore, the clinical manifestations of this disease are neurological symptoms, often presenting as acute abdominal pain. However, abdominal examinations usually yield no positive findings, making it easy to misdiagnose as a neurosis or hysteria. In some cases, because of accompanying symptoms like abdominal distension, vomiting, constipation, low-grade fever, and leukocytosis, it's misdiagnosed as an acute abdomen, leading to surgery..."
"Because this disease is very rare in our country, there's little related research, and therefore, very little general awareness. If I hadn't happened to read a cutting-edge international journal, I wouldn't have made the connection."
"According to the progression of this disease, seizures can also occur during a severe attack... This is just my perspective. I welcome any corrections from the directors."
Wu Ting's voice, clear and firm, echoed in the conference room.
Only after he had finished his entire analysis did the directors begin to discuss it.
"Based on Wu Ting's analysis, the patient's symptoms do seem quite similar."
"But similar symptoms don't necessarily mean it's this specific disease. There are many conditions with similar clinical presentations."
"It would be too much of a coincidence to base a diagnosis on just a few case studies he happened to stumble upon."
The attending directors were all seasoned veterans; of course, they wouldn't believe in something like sheer luck.
"That said, Wu Ting's analysis has some merit. Let's add some relevant tests based on the diagnostic criteria for porphyria."
"Dr. Qin, you arrange for a urinary ALA excretion test and a porphobilinogen excretion test. Also, do a qualitative porphobilinogen test—the Watson-Schwartz test—to diagnose the condition."
Huo Yun made the final decision.
The other directors nodded slightly in agreement. Of course, this was just one more possibility to consider.
As the directors continued their discussion, a call came from the patient's ward.
Qin Donglai saw it was Luo Ming and answered immediately. After hearing the report, Qin Donglai's eyes went wide as he stared at Wu Ting.
"Dr. Qin, what's the situation?"
Huo Yun asked, looking at the somewhat flustered Qin Donglai.
After hanging up, Qin Donglai said in disbelief:
"You all might not believe this, but it's just as Wu Ting predicted. The patient just had a seizure. Dr. Luo is already handling it, and the situation is mostly under control."
After hearing Dr. Qin's words, the directors couldn't stay in their seats. They all turned in unison to look at Wu Ting.
"Immediately proceed with the planned tests and get the results as soon as possible. If it really is porphyria, then we'll have solved a difficult and puzzling case."
"This case is quite classic. If it turns out to be the rare porphyria, we can submit it to a case competition later!"
"Dr. Wu, you regularly read original articles from cutting-edge international journals. It seems your fundamentals are very solid."
"Excellent. That's a great habit. When I get back, I'm going to tell the junior doctors in my department to learn from you."
"Wu Ting, I'll remember that name. Director Huo, your Emergency Department really produces talented people."
Huo Yun also felt a surge of pride. He laughed heartily, his gaze toward Wu Ting filled with admiration.
"Wu Ting, you've done well."
"Since we now have a direction for the patient's diagnosis and treatment, let's conclude today's multi-department consultation here. Once the test results are out, I'll have Dr. Qin notify everyone. Thank you all for taking the time to participate in this consultation."
Huo Yun knew that the directors' time was precious, so he didn't waste it on pleasantries.
"Alright, we'll look forward to the test results."
Before leaving, the three directors offered some more words of encouragement to Wu Ting, then went their separate ways.
[Ding! The host has completed a multi-department consultation with several department heads and proposed a viable plan. Congratulations to the host for obtaining the entry from Dr. Huang Hong: Clearing Heat, Dissolving Phlegm, and Promoting Bowel Movement Method (Yellow). This is Dr. Huang Hong's specialty National Medicine technique. It purges heat through the bowels, clears heat, and dissolves phlegm, effectively promoting the treatment of a patient's pulmonary infection. Note: In National Medicine, the gall bladder, stomach, large intestine, small intestine, triple burner, and bladder are called the Six Fu-organs.]
[Recommended Entry Combination: Tracheotomy (Yellow) + Clearing Heat, Dissolving Phlegm, and Promoting Bowel Movement Method (Yellow) = Combined Traditional Chinese Medicine and Western Medicine Treatment for Tracheotomy (Purple), a unique, original tracheotomy procedure combining National Medicine and modern medicine.]
[Tracheotomy is a common method for establishing an artificial airway in critically ill patients. It can maintain the patency of the patient's respiratory tract and facilitate airway management. However, after a tracheotomy, bacteria can easily travel through the respiratory tract into the lungs, thus increasing the risk of pulmonary infection. Currently, Western medicine is typically used to treat post-tracheotomy pulmonary infections. While it can alleviate symptoms in the short term, the therapeutic effect is not ideal. By combining it with National Medicine methods, this problem can be perfectly solved.]
[Does the host wish to combine the entries?]
Wu Ting, of course, combined the entry immediately. Once he possessed the Combined Traditional Chinese Medicine and Western Medicine Treatment for Tracheotomy (Purple), Wu Ting truly understood the uniqueness of this combined therapy.
'This has the full potential to be published as a top-tier journal paper.'
It seemed that after finding a suitable opportunity to use this combined incision skill, Wu Ting would try to write his own original paper.
As for Cheng Feng's previous research project, "The Effect of 15°C Antiseptic Solution on Pain Reduction During Debridement of Superficial Second-Degree Burn Wounds," Wu Ting planned to give it back to him.
After all, Wu Ting was now confident he could secure a permanent position at the hospital all on his own.
The multi-department consultation had been a huge success. The only shame was that he had only obtained an entry from Associate Chief Physician Huang Hong this time. 'In the future, I have to get Dr. Qin to bring me along more often. After all, a single entry dropped from one of these big shots is enough for me to work on for a long time.'
After the multi-department consultation ended, and before the test results for the porphyria patient came back, Wu Ting threw himself back into his daily work.
...
Qin Donglai, meanwhile, had entered Huo Yun's office with a portable hard drive.
"Director Huo, were you surprised by Wu Ting's performance at the multi-department consultation today?"
Qin Donglai asked with a broad grin, looking at Huo Yun.
Huo Yun nodded. "Yes, Wu Ting really did surprise me. Whether the porphyria diagnosis is ultimately confirmed or not isn't what I value most. What I appreciate is his youthful drive and rare courage."
"Of course, his habit of spending time outside of work to read and learn from cutting-edge international journals is also excellent. Before him, I'd only ever seen that kind of initiative in Cheng Feng."
"It's just a shame that Wu Ting's academic background and research experience are a bit lacking."
Huo Yun sighed softly. There wasn't much time left before the decisions on permanent hospital positions were made.
He was optimistic about Wu Ting's character, but he lacked a justifiable reason to keep him on.
Wu Ting's "hard skills" weren't convincing enough. In comparison, many other residents were a step ahead in terms of background, connections, and overall capabilities.
"Director Huo, didn't you tell me before to give Wu Ting more opportunities when I had the time? Over this period, I've truly discovered his talent for clinical surgery."
Qin Donglai handed the portable hard drive to Director Huo.
"Director Huo, these are a few surgeries I supervised Wu Ting on recently. Among them is a modified combined Kirschner Wire fixation and tendon suture method he performed on a patient, as well as several other tendon suture surgeries he completed at Yu State Hospital. This kid's tendon suturing skills are already at the level of a senior attending physician..."
"You might not believe this, but I only taught him an incision technique once. Just a few days later, he had already mastered it..."
Qin Donglai explained animatedly while playing the videos of Wu Ting's surgeries for Huo Yun.
At first, Huo Yun thought Qin Donglai was exaggerating. But when he actually saw the videos of Wu Ting's surgeries, he was too shocked to speak.
Time ticked by, second by second. The only sound in Huo Yun's office was the audio from the videos.
Finally, all the surgery videos finished playing.
Huo Yun picked up the thermos next to him, took a long gulp, and then said with great gravity:
"Donglai, it seems our Emergency Department has produced an incredible seedling!"
"You and I need to put more effort into this. A talent like him requires special cultivation!"