Chapter 433: Highly Commended

The cold wind was biting.

Aside from Professor Shen and Mao Mao, none of the guests expected the hospital ward rounds to be so serious, nor did they imagine that the seemingly amiable Yang Zhuren would change his face in an instant, making one afraid to meet his gaze.

"During the last season filming at the law firm, I thought they were too serious. I didn't expect that compared to the doctors at the hospital, they were actually quite gentle."

"Indeed, is Yang Zhuren about to start scolding people?"

"I can't even stand it while not being on-site; my legs are shaking a bit. Is Yang Zhuren doing this on purpose?"

The guests whispered to one another.

They lowered their voices subconsciously, as if worried that Yang Zhuren inside the screen might hear them.

……

"The gallbladder is normally located within the gallbladder fossa on the anterior edge of the interface between the left and right lobes of the liver. It is relatively fixed and not prone to torsion. To this day, the exact cause of gallbladder torsion remains unclear."

"However, the medical community believes there are several possibilities. First, congenital anatomical variation: floating gallbladder, where the gallbladder is free-hanging, drooping, and has increased mobility."

"Second, in the elderly, fat atrophy and ligament laxity lead to increased gallbladder mobility."

"Third, kyphosis causing visceral ptosis and positional changes."

"The fourth inducing factor is changes in body position during exercise or strong gastrointestinal peristalsis; even bile stasis or gallstone impaction can induce gallbladder torsion."

"The patient self-reported having briskly walked before the abdominal pain, which gave me my suspicion." Ji Xiang was not intimidated by Yang Zhuren's aura; his answers were well-reasoned and clear.

"Intermittent pain, tenderness point in the mid-abdomen, differential diagnosis..."

After Ji Xiang finished speaking about the inducing factors of gallbladder torsion, he began to discuss the differential diagnosis. Yang Zhuren's expression did not change, but Ji Xiang's words stirred up giant waves deep within his heart.

It looked as if Ji Xiang was "parroting books," but senior doctors all knew that Ji Xiang was recounting his own mental process at the time.

In other words, in that very instant, Ji Xiang had thought of countless things from the muscle guarding observed during the physical examination.

"In summary."

After 3′12″, Ji Xiang finished speaking, still wearing a smile, "Because gallbladder torsion is a relatively rare disease, coupled with numerous differential diagnoses, I could only make a preliminary diagnosis, suspecting gallbladder torsion and recommending the patient undergo a Fubu CT of the upper and mid-abdomen."

"Why was there no cholelithiasis in the diagnosis?" Yang Zhuren suddenly asked an extremely peculiar question.

"There is no significant correlation between gallstones and gallbladder torsion; about 70% of gallbladder torsion patients have no gallstones found at the time of diagnosis."

"Congenital factors are the main cause of gallbladder torsion in children, while age-related physiological changes are more inclined to be the cause of gallbladder torsion in adults."

"There is also no significant correlation between the direction of gallbladder torsion and the degree of torsion—180°, incomplete torsion, >180°, or complete torsion."

"Later, after the patient underwent auxiliary examinations, it confirmed the aforementioned judgment; the diagnosis was clear: gallbladder torsion with Acute Acalculous Cholecystitis."

After hearing Ji Xiang finish, Yang Zhuren looked earnestly at this young man in the prime of his life.

He wanted to pose a difficult problem for Ji Xiang, but the so-called "difficult problem" could not stump him at all; Ji Xiang answered fluently.

From the initial caution to the accidental discovery that the patient's condition was wrong, and from the directional physical signs to the various judgments, it was clear, logical, and impeccable.

Yang Zhuren was somewhat dazed; even if he were to answer this question himself, it would be impossible to be as simple and clear as Ji Xiang's answer.

"Doctor Ji Xiang, this is a rare disease; how do you know so much about it?"

Yang Zhuren's tone finally softened, and he asked with a peaceful expression.

"Our local hospital has encountered similar cases," Ji Xiang smiled. "Teachers Pu Heyun, Liu Yulin, and Xie Guanghua wrote a similar report—'One Case of Laparoscopic Cholecystectomy for Gallbladder Torsion with Necrosis'."

Yang Zhuren nodded.

"As for the Medical Record..."

"Next time we receive a patient, you write it," Yang Zhuren said, looking at Ji Xiang.

"Okay."

……

……

In the Review Room, there was dead silence.

The atmosphere on set was too oppressive. The host's bald head shone for a moment, one corner of his mouth twitched, and he began to save the situation.

"I didn't expect that our reality show's Intern would be this impressive," the host chuckled.

The layperson guests were awestruck, not knowing how to interject even if they wanted to say something.

The semi-expert guest Mao Mao stared blankly at Ji Xiang on the screen, not knowing what she was thinking.

Professor Shen was the only expert; he was even more silent and ignored several reminders from the Camera Crew, just frowning in deep thought.

"Professor Shen, are Interns like Ji Xiang common in hospitals?" Seeing that no one picked up on his words, the host had to throw out a question to forcefully liven up the atmosphere.

"Intern?" Professor Shen gave a bitter smile.

"Yes, he is also a Standardized Training Doctor."

"Let's put it this way," Professor Shen saw the screen switch to another ward and immediately lost interest. Remembering his role as a guest, he began to talk, "Doctor Ji Xiang gives me an illusion: he is not an Intern without any Clinical experience, but rather someone who has been struggling in the Clinical field for over a decade, slick..."

As he spoke, Professor Shen felt his description was a bit off and laughed, "Slick is a word we occasionally use to describe people; cut this part out."

The host also laughed, and the matter passed. As for whether it would be cut in the end, that would depend on Fan Dao's decision.

"How should I put it? He is like the kind of doctor who has had a Medical Malpractice incident, almost been sentenced, and carries a deep sense of guilt in his heart... I can perceive a very strong aura of Obsessive-Compulsive Disorder in him."

"Obsessive-Compulsive Disorder? How so?"

"Everyone knows that there are low-probability events in everything. Low-probability events in medicine are the most troublesome. Seeing dozens or hundreds of patients every day, even the smallest probability becomes a high-probability event over time."

"If you don't make mistakes, it's because you see too few patients."

"But the medical industry has its own particularities. What if you make a mistake? Those are human lives. So many doctors have Obsessive-Compulsive Disorder, just like Doctor Ji Xiang. Even though the patient has already gone to the Emergency Department, he still worries that the Emergency Department is busy and the Emergency Doctor didn't have time to remind the patient to pay attention to their body position when vomiting."

"As for the physical examination, if you find a problem, you must continue to investigate; that's nothing special. I'm just moved that such a young doctor, who isn't even in charge of beds yet, knows how to be responsible."

"Responsible?" The host was somewhat confused.

"Yes, Intern Doctors don't have to be responsible, so the pressure isn't that high, and work often has problems. Only when you are in charge of patients yourself and take responsibility are you a true doctor."

"Not to mention saving lives, just in terms of giving one's all, I think Doctor Ji Xiang is already a qualified Clinical doctor."

The evaluation given by Professor Shen was high enough.

(End of chapter)