Chapter 303: Following Good Advice

The 120 emergency Doctor looked slightly ashamed.

"You diagnosed myocarditis just because a cold wouldn't go away? Hurry back." Meng Qingfei waved his hand, shooing him away with great impatience.

"Doctor Meng." The 120 emergency Doctor glanced at Meng Qingfei's name tag and said with some embarrassment, "Let me know if there are any results."

After saying this, he left a contact number.

Meng Qingfei did not refuse; he wrote down the number and began the physical examination.

The Patient was a 32-year-old male, 176cm tall, weighing about 65kg.

He stated that he had eaten lunch with colleagues at 12:00 PM and, after drinking half a cup of white liquor, experienced chest pain and chest tightness, followed by vomiting; the vomitus consisted of gastric contents with no coffee-ground-like material observed.

Physical examination: heart rate 102 beats/min, blood pressure 154/103mmHg; no other positive signs were found during the physical examination.

The Patient looked to be in poor spirits while lying on the bed, and although his vital signs were stable, he clearly had a major problem.

After finishing the medical history inquiry and physical examination, Meng Qingfei stood beside the Patient without speaking; Ji Xiang noticed his right-hand fingers were constantly pinching as if he were fortune-telling.

His thumb tapped rapidly against his other fingers; if someone had provided a Peach Wood Sword for his other hand and he had been muttering under his breath, the vibe would have been complete.

Ji Xiang was very curious about what Meng Qingfei was doing.

Although the Patient looked very uncomfortable, it was not too urgent, so Ji Xiang did not go to the System Operating Room.

After ordering other examinations, Meng Qingfei briefly left the Emergency Rescue Room and returned to the Consultation Room to ponder.

"Meng Laoshi, may I disturb you for a moment?" Ji Xiang asked.

"Go ahead." Meng Qingfei's fingers were still tapping.

"What are you..."

"Differential diagnosis," Meng Qingfei said. "The Patient has had chest pain for nearly 12 hours, and since the pain is so pronounced, there is a high probability of an organic issue."

"Differential diagnosis one, Aortic Dissection.

Generally, when a patient has chest pain accompanied by high blood pressure, one must first rule out Aortic Dissection.

However, the blood pressure difference between the Patient's left and right upper limbs is not significant, and dissection pain usually presents as tearing or knife-like; one can first complete examinations related to the abdominal major vessels to rule it out, and perform a chest-abdominal Aortic Dissection CTA if necessary.

The Enhanced CT is off duty now, so it can't be done; I'm not considering it for the moment."

"Second, Viral Myocarditis..."

"Third, Spontaneous Pneumothorax..."

"Fourth, Acute Pancreatitis..."

"Fifth, Myocardial Infarction..."

Meng Qingfei was "talking to himself," his right thumb constantly tapping on his other fingers, as if he performed a differential diagnosis with every tap.

Yet, he still hadn't found the correct answer.

Soon, the emergency Serum Troponin results returned, indicating negative, which temporarily ruled out Viral Myocarditis and Myocardial Infarction.

Now Meng Qingfei was even more puzzled.

Ji Xiang also felt the Patient was very strange, so he focused his mind and went to the System Operating Room.

Meng Qingfei's lips had already started moving; he was muttering, concentrating on performing the differential diagnosis.

His level was actually quite good; patients in the Emergency Department generally had relatively simple conditions, unlike the Patient before them, for whom he didn't even know who to call for a consultation.

"Meng Laoshi, I want to go take a look at the Patient," Ji Xiang suddenly said.

"I just finished checking," Meng Qingfei replied casually. "What are your thoughts?"

"When you were doing the physical examination just now, you didn't check the Patient's armpits."

"Oh, indeed, but not every..." Meng Qingfei was using eighty percent of his focus on the differential diagnosis and had intended to casually tell Ji Xiang that not every place needed to be checked.

It was like checking the private parts for chest pain; you'd get beaten to death by the Patient and the Family Member.

Even if you weren't beaten to death, if some busybody posted it on social media, it would likely be a social death.

However, Ji Xiang had only said the beginning of a sentence, and Meng Qingfei had already thought of many things.

"Are you saying there might be a problem with the mediastinum?!"

Ji Xiang's words opened up Meng Qingfei's line of thought.

"Everything else seems fine for now; the only thing missed was the armpits," Ji Xiang answered calmly.

Meng Qingfei's eyes lit up instantly; he strode out, arrived at the Emergency Rescue Room, opened the Patient's clothes, and instructed the Patient to lift his arms.

When his hand touched under the armpit, a slight sensation of crunching snow was transmitted; Meng Qingfei examined it carefully, and there was indeed an atypical sensation of crunching snow.

"Damn it, this really isn't an Internal Medicine matter; go get an emergency CT," Meng Qingfei said hurriedly to the Nurse. "The Patient's condition has some issues; I'm taking the Patient for an examination. If any patients come, ask Li Yisheng from Internal Medicine to take a look for me first!"

After saying this, he rushed out to prepare the order, then remembered something, turned back, and said, "Call the General Thoracic Surgery department and have them prepare a bed."

Ji Xiang truly admired Meng Qingfei a little.

For chest pain, the armpit is not a place that must be checked, and spontaneous Mediastinal Emphysema is also extremely rare.

He had mentioned it once, and Meng Qingfei followed the flow of good advice and listened.

He was truly "following the flow," like the waters of the Yellow River, overturning all his previous assumptions.

A line of thought that isn't stubborn is admirable, and his brain turned extremely fast, only a tiny bit slower than the System NPC.

"Xiao Ji, you stay here. If there are patients, have Li Yisheng from Internal Medicine see them first. Don't let them leave; wait for me to return," Meng Qingfei said hurriedly, pushing the Patient and running all the way.

The oxygen bag on the gurney almost fell off; Meng Qingfei clamped it with his arm and disappeared around the corner.

"Xiao Meng's diagnosis is quite good, he's just a bit impatient." The Internal Medicine Doctor had already been woken up and was standing in the hallway; seeing Meng Qingfei disappear, he gave a light evaluation.

Ji Xiang felt a little regretful; he also wanted to know the Patient's final diagnosis, but Ji Xiang didn't say no, instead staying behind according to Meng Qingfei's wishes.

"You must be Ji Xiang. I heard you broke the record of so many years at the grand competition," Li Yisheng from Internal Medicine asked, looking at Ji Xiang.

"Just luck," Ji Xiang smiled.

"Xiao Meng really likes you. By the way, I heard the patient who contracted Tetanus a while ago was also diagnosed by you?"

"Just luck."

Doctor Li of the Internal Medicine Department took a deep look at Ji Xiang; one incident could be a coincidence, but one coincidence after another definitely meant something was wrong.

"What was the diagnosis for that Patient just now?" Doctor Li of the Internal Medicine Department asked.

"I don't know either. I just said something at random, and Meng Laoshi seemed to have a diagnosis," Ji Xiang deflected everything, claiming he didn't know regardless of what others asked.

"This is a case for our Internal Medicine Department, but... sigh." Doctor Li sighed, then suddenly smiled again, "Everyone knows little Meng's diagnoses are good; when patients from other hospitals come for consultations, the Nurses go straight to little Meng. That's fine too, it saves us the trouble."

"Little Meng looks like a slacker, but he's actually quite good. You're also quite impressive; with so many doctors in the Emergency Department, you just happened to pick little Meng. I see you always following him to take shifts."

"Meng Laoshi is funny when he talks. When I first arrived for Standardized Residency Training, Meng Laoshi told me the Emergency Department restroom had been blessed, and that patients with Urological Calculus all like to use the toilet here."

Ji Xiang laughed.

(End of chapter)