Chapter 794: Damn it, he's showing off again!

"Because omental infarction is a self-limiting disease and does not require surgical treatment, it is fundamentally different from the treatment plan for acute appendicitis. Therefore, your refusal to undergo a Fubu CT makes it impossible for us to rule out other conditions, and according to regulations, you are required to sign."

After Ji Xiang finished speaking, he looked straight at Dr. Merz, his gaze firm and subtly carrying the authority of a senior doctor.

It was not a system skill, but the unwavering authority Ji Xiang had naturally accumulated from performing many surgeries.

Ten seconds later, seeing that Dr. Merz did not say a word, Ji Xiang continued, "Dr. Merz, if you are not confident in your own diagnosis, I suggest you listen to us."

"!!!" Dr. Merz almost spat out a mouthful of old blood.

He had come thousands of miles to the Second Affiliated Hospital just to cause trouble for Lin Jiuze.

Unfortunately, he had encountered a Great Demon King who countered him at every turn.

No matter what he did, nothing went his way, and he couldn't even understand the surgeries being performed.

He had even inexplicably developed acute appendicitis, and the Great Demon King was so black-hearted that he wouldn't allow him to have surgery.

He wasn't a doctor at all! He was a Great Demon King! A true, genuine Great Demon King.

Dr. Merz was screaming inside.

But Dr. Merz was already exhausted by the illness and had no way to resist.

"Xiao Ji, has the CT been done?"

Just as they were chatting, Bai Chuzhang pushed the door open and entered.

Seeing Bai Chuzhang arrive on call like a summoned beast, Zhao Zong immediately lowered his head.

He felt that today's situation could no longer end well, and he felt a slight sense of regret.

It was all his own fault; if he hadn't wanted to have more communication with the great philanthropist Ji Xiang, he wouldn't have asked him to act as a "translator."

If he hadn't come to translate, Dr. Merz would already be on the operating table by now, and Bai Chuzhang wouldn't have come at all.

If he had just dragged Dr. Merz to surgery, he would have seen the appendix by now; it would only take a few snips to remove it, and there wouldn't be so much trouble.

The subsequent events were completely out of control, and Zhao Zong only hoped that the great philanthropist Ji Xiang wouldn't make things impossible to resolve.

"Bai Chuzhang, we believe the diagnosis is still open to debate and suggest a Fubu CT. Dr. Merz won't sign and only demands surgery; it's very difficult for us to handle," Ji Xiang said.

"This is Chu Lvshi, the legal consultant I invited from the foreign affairs department," Bai Chuzhang said, pointing to a man in his fifties behind him. "Chu Lvshi, this is the Ji Xiang I mentioned to you."

"Doctor Xiao Ji, hello." Chu Lvshi reached out and shook hands with Ji Xiang.

His gaze swept over the doctor-patient communication document, he greeted Bai Chuzhang, and then took the document and asked Ji Xiang to step outside with him.

"It's hard for everyone; it's better to be cautious about some things," Chu Lvshi chatted with Ji Xiang while looking at the document. "I work at a law firm, and one of my clerks was just complained about."

"Why the complaint?" Ji Xiang asked.

"She answered a person's phone call, and when the clerk asked for the case number, the person immediately hung up and filed a complaint. He meant that there must be a cover-up, otherwise why would they need a secret code."

"..." Ji Xiang felt this Chu Lvshi was quite interesting.

Since they had just met and things were a bit awkward and unfamiliar, he had casually used a pun to bridge the distance between them.

This was emotional intelligence; Ji Xiang felt it was very comfortable to talk to someone with high emotional intelligence.

"It's not just you; the patients you encounter are quite similar to the plaintiffs and defendants we encounter." Chu Lvshi read the communication Ji Xiang had written word for word, chatting away as if he could multitask.

"Haha, I didn't expect you to have so many troubles too. I always thought only doctors encountered so many bizarre patients and family members."

"That's right, there are plenty of unreliable things. For example, this time last year, I went to the law firm and saw an eighty-year-old man leaning on a cane, cursing. I asked my assistant what was going on, and the assistant said the old man's children had taken all his money."

"Sigh." Ji Xiang sighed.

Chu Lvshi looked up at Ji Xiang, the corners of his mouth lifting. "Doctor Xiao Ji, did you think it was the children not supporting the elderly?"

"Uh, isn't it?" Ji Xiang was taken aback.

"I thought so too at the time, but after looking into it, I found out that after the old man learned to use the internet, he started tipping female influencers on a livestreaming app, spending tens of thousands of yuan a month. His children put his money into a fixed deposit so he couldn't tip the female influencers."

"..."

"So, that's just how things are in this world. We lawyers have seen all kinds of human nature after doing this for so long. They say the walls of a hospital hear more prayers than a church; our law firm is a bit behind, but we've seen our fair share of the world."

"Chu Laoshi."

"Hmm?" Chu Lvshi responded casually while looking down at the communication Ji Xiang had written.

"In the Imperial Capital, is there a quite famous lawyer who was slapped during a court hearing after a dispute with the other party, and later when he went to get his injuries examined..."

Chu Lvshi froze for a moment. He looked up, his eyes narrowing into slits.

"He knocked out 7 of his own teeth."

"How did you know?" Chu Lvshi was startled, then asked cautiously.

"I heard it from a teacher in the Imperial Capital."

Chu Lvshi frowned, and only after a few seconds did he nod. "Everyone suspects it, but there is no concrete evidence. But having said that, Doctor Xiao Ji, your communication document is written really well."

Ji Xiang knew that Chu Lvshi did not want to mention such sensitive matters.

He had originally thought that the experiences of empathy in the system and the things mentioned by the system NPC did not exist, but after asking casually and seeing Chu Lvshi's expression, Ji Xiang felt a trace of suspicion.

"It's alright."

"I've seen many of your doctors' communications, and they all have problems. This one of yours could serve as a template," Chu Lvshi said with a smile, the matter Ji Xiang had just brought up seemingly forgotten. "Young but meticulous, no wonder Bai Chuzhang values you so much."

"As long as there are no problems."

"Yes, I don't see any problems. Let the patient sign."

Chu Lvshi then found Bai Chuzhang, who was communicating with Dr. Merz, and whispered his opinion in his ear.

"Dr. Merz, I suggest you have a CT scan," Bai Chuzhang persuaded gently. "After all, we need to rule out low-probability issues."

"Low probability! I am the patient now, and I diagnose..."

"You are the patient now, and you are by no means an expert in Gastrointestinal Surgery. If you insist, I suggest you contact your expert friend in Massachusetts," Ji Xiang interrupted Dr. Merz.

This was the second time Dr. Merz had heard Ji Xiang tell him to contact his expert friend in Massachusetts.

As for the last time, it was when they encountered a patient diagnosed with Patent Foramen Ovale.

Dr. Merz, who had been firm in his belief that he was being cheated, targeted, and repeatedly trampled under the feet of the Great Demon King, suddenly felt a trace of wavering.

"Dr. Merz, you were a doctor, and now you are a patient; please put yourself in a doctor's perspective and think about it."

Dr. Merz listened to Ji Xiang's words and fell into deep thought.

"When someone unprofessional or someone who thinks they are professional gets involved in a professional field, it is undoubtedly a disaster. You are a doctor; I think you understand all of this."

Yes, that is indeed a disaster.

No! Dr. Merz realized in an instant that Ji Xiang was "mocking" him.

That young Great Demon King was saying he was unprofessional!

He was making a simple diagnosis and treatment complicated, and the dramatic ending was the unprofessional doctor tasting the bitter fruit himself!

Dr. Merz was angry, very angry, especially angry.

But when he met Ji Xiang's gaze, he immediately backed down and didn't express his anger at all.

The diagnosis of Patent Foramen Ovale was still fresh in his mind; at that time, he had waved the Electrocardiogram report in front of the young Great Demon King, only to be miserably slapped in the face in the end.

Facts proved that the Patient did indeed have Patent Foramen Ovale.

Not only that, after the surgery, Wembanyama also seemed to get better day by day.

Dr. Merz was silent.

"Do you need a medical consultant?" Ji Xiang asked.

"I'll make a call." Dr. Merz was slightly troubled.

Because he didn't understand Chinese, he couldn't relay some of the examination data.

"I can translate the data." Ji Xiang noticed Dr. Merz's difficulty immediately and offered.

How detestable!

Dr. Merz did not feel that Ji Xiang was showing goodwill with his "generosity"; instead, he believed this young Great Demon King was suppressing him.

At the same time, the pain in his abdomen intensified.

This was all the young Great Demon King's fault!

Dr. Merz dialed the number of a familiar Gastrointestinal Surgery doctor.

"John, there is something I would like to consult you about."

"Oh, where are you? I haven't seen you lately," the doctor on the other end of the phone asked.

"I... I think I have Acute Appendicitis."

Just as Dr. Merz said this, the phone was taken away by Ji Xiang.

The incident happened suddenly, and Dr. Merz didn't notice; when he wanted to snatch the phone back, he found that the young Great Demon King had already started communicating with his friend.

The young Great Demon King began to state the condition; these were things Dr. Merz could understand.

"On the Ultrasound image, I see a bean-shaped, oval-shaped space-occupying lesion appearing on the abdominal wall. The quantity is small, and it is not very clear."

Dr. Merz could not believe this was how a doctor reported a medical history.

But Ji Xiang was stating it very seriously.

"Because the Ultrasound was not performed by me, I can only make a judgment based on the Ultrasound image."

The doctor on the other side said something, and Ji Xiang listened attentively.

"I think we shouldn't rush to diagnose it as Acute Appendicitis, but should first perform a Fubu CT and an Enhanced CT to rule out the possibility of omental infarction. If the CT confirms it, I suggest doing an Enhanced CT to decide whether surgery is needed."

Dr. Merz was stunned when he heard Ji Xiang say this.

Not only did he have to do a CT, but also an Enhanced CT, yet he only had Acute Appendicitis!

If this were at Massachusetts General Hospital, the insurance company would absolutely not reimburse this expense!

It was simply too much; the young Great Demon King was not only trying to challenge him but also trying to challenge the Expert far away at Massachusetts General Hospital and the insurance company.

"Alright, I'll hand the phone to Dr. Merz, and you can talk to him. Dr. Merz won't listen to my judgment; he insists on surgery. You know that whether it's an incision at McBurney's Point in the lower right abdomen or a laparoscopy, neither can satisfy the needs of the surgery.

Furthermore, if the Enhanced CT shows no issues, performing surgery for a self-limiting disease is definitely unacceptable."

As he spoke, Ji Xiang handed the phone to Dr. Merz.

"John..." As Dr. Merz spoke, the person on the other end of the phone interrupted him.

"Merz, who was the person who just explained the condition to me?" the doctor on the other end of the phone asked.

"..." Dr. Merz glanced at Ji Xiang.

The perspective from curling up on the examination bed was different from the normal perspective; Dr. Merz saw that the young Great Demon King was so tall and invincible.

Was it really Appendicitis? A trace of doubt appeared in Dr. Merz's heart.

"He is the Chief Surgeon who performed the surgery on Wembanyama."

Dr. Merz whispered to reveal Ji Xiang's identity.

"Damn it!" Dr. John cursed, "Why would a Sports Medicine doctor know how to read an Ultrasound?"

"I know how to, too."

"No! Merz, an Ultrasound of omental infarction is very difficult to judge; the best way is to do a CT. Do you remember that troublesome case I encountered a few years ago?"

Dr. Merz was stunned.

He vaguely remembered, but John hadn't told him the specific details of the matter. This was private, and Dr. Merz hadn't inquired carefully.

"A Patient was examined and considered to have Cholecystitis. The hepatobiliary doctor performed the surgery, only to find that the Patient's gallbladder was fine and had no problems at all; the problem was the Patient's greater omentum."

"!!!"

"This damn disease looks so much like Appendicitis and Cholecystitis; if you don't do a Fubu CT, there's no way to rule it out. But the insurance company firmly refuses to reimburse the relevant Patient's expenses."

Dr. Merz did not expect his friend to completely stand on the side of the Great Demon King.

"You don't understand the details of this; I suggest you listen to the local Expert's opinion."

After talking for a long time, Dr. John gave his opinion decisively.

"Why do you think he is an Expert?" Dr. Merz asked.

He kept his voice extremely low, fearing that Ji Xiang might hear.

But Ji Xiang had good hearing and heard it clearly. However, Ji Xiang did not have any bad thoughts about Dr. Merz because of this; as long as the Patient was willing to have a CT scan, the Patient's questioning didn't matter.

What Ji Xiang was more concerned about was that an Enhanced CT must not be needed, otherwise the surgery would be very difficult, and he feared no one at the Second Affiliated Hospital had the experience.

Everyone is safe and sound, which is good.

"Merz, you stupid thing, I really want to stuff the sandwich I didn't finish this morning into your mouth!"

"..."

"There is no why, you just need to listen to the Expert's opinion. I still have to perform a damn surgery, and I haven't finished my outpatient quota for this month. If I still want to go fishing at sea this weekend, I have to go to the Outpatient Department after the surgery to see those boring patients to make up the number of outpatient patients for this month.

Merz, do you know how busy I am!"

Dr. Merz heard a series of dial tones from the other side helplessly, and only then did he hang up the phone.

"Dr. Merz, will you have the CT scan or sign the refusal?" Ji Xiang waved the communication and consent form in his hand.

"..." Dr. Merz looked helplessly at the Great Demon King who was showing off his power in front of him, speechless.

He managed to show off again!

Damn it!

Omental infarction, Dr. Merz vaguely knew that this disease should involve blood vessels.

But being fine is one thing; once something goes wrong, assuming a large area of the omentum has no blood supply, the next step is an Acute abdomen!

If diagnosis and treatment are delayed, the next step would be difficult-to-treat diseases like bacteremia, and there is a high probability of infection, Toxic shock, and even life-threatening consequences.

It would definitely not be as simple as Acute Appendicitis.

Thinking of this, Dr. Merz became a bit anxious.

"I want to have a CT scan! An Enhanced CT!!"

After speaking, Dr. Merz added, "It doesn't matter if the insurance company doesn't reimburse it, I'll pay for it myself!"

The fear of large-scale necrosis of the omentum had already exceeded Dr. Merz's desire to defeat the young Great Demon King in front of him; he endured the severe abdominal pain and said it almost wailingly.

"What did he say?" Director Bai asked.

"Dr. Merz agreed to have a CT scan, but he also wants an Enhanced CT." Ji Xiang was a bit helpless.

"Do you need me to contact someone?"

There is no doctor on duty for Enhanced CT at night because this examination is not an emergency item.

If it must be done, Director Bai would need to call the relevant doctor from home and have them turn on the machine and prepare.

Ji Xiang thought for a moment, "Better call them. Although I think the possibility is low, what if? If an Expert from Massachusetts General Hospital dies of illness in our hospital, it won't be easy to explain."

"!!!"

The last sentence startled Director Bai.

It is no exaggeration to say that the consequences would be unimaginable.

Director Bai's scalp even went numb at the thought of the chain reaction brought about by a Massachusetts Expert "dying" at the Second Affiliated Hospital.

Contacting the CT Room, Director Bai took people to send this "big trouble," Dr. Merz, to have the examination.

The CT image showed a large area of fat density shadows with blurred edges and unclear boundaries.

What the hell is this?

The doctor on duty in the CT Room looked at the image in confusion; he had no idea how to diagnose it.

"It's omental infarction," Ji Xiang said very firmly, "but for now, surgery is not needed; just observe for a few days."

Director Bai asked tentatively, "Really? Anyway, Niu Zhuren from the CT Room is coming, should we do an Enhanced CT while we're at it?"

Ji Xiang did not insist, but agreed with Director Bai's opinion.

Anyway, it only requires rest; looking at it now, Dr. Merz's omental infarction is a self-limiting disease.

Whether or not to do an Enhanced CT makes no difference to himself or to Dr. Merz's illness, but for Director Bai, it could buy peace of mind.

Having experienced Empathy countless times, Ji Xiang subconsciously stood in others' shoes to think about problems.

When Niu Zhuren arrived and saw the image, he reached the same conclusion as Ji Xiang, and only then did Director Bai feel relieved.

However, he still insisted on doing an Enhanced CT.

Dr. Merz was having the examination, and listening to the buzzing sound, Director Bai asked, "Niu Zhuren, it's fine not to perform surgery, what's going on?"

"Director Bai, is the omental infarction you understand something like omental Thrombosis?"

"Yes." Director Bai nodded.

"Actually, primary omental infarction often occurs in children and adults. The pain is often located in the right upper or lower abdomen, and it is easily misdiagnosed as Appendicitis or Cholecystitis. Its only predisposing factor is obesity in children."

"I read in a report that about 0.3% of patients with Acute Appendicitis are misdiagnosed; they should actually be diagnosed with omental infarction."

Director Bai truly did not understand this.

Then again, a Medical Affairs Department director who started as a neurosurgeon cannot be omniscient.

He listened very seriously to Niu Zhuren's explanation of omental infarction.

"Primary infarction is prone to occur in the right upper abdomen, which may be related to the fact that the greater omentum there is longer and has greater mobility."

"The lower abdomen is also not uncommon; most are self-limiting diseases, and it will get better on its own after resting for a few days."

"So when I see clinical reports about conservative treatment for Appendicitis or Cholecystitis, I feel it's better to do a CT scan to rule things out."

"However, it is now said that we are abusing CT scans; after drawing blood and doing an Ultrasound, we still have to scan a CT. I estimate that 99.7% of Appendicitis patients cannot accept that."

Niu Zhuren said, laughing out loud.

"Is surgery needed?"

"The greater omentum has many blood vessels supplying it, so it is generally not needed."

Niu Zhuren began to show off his skills, carefully explaining to Director Bai what kind of omental infarction truly requires surgery.

Ji Xiang stood in the corner watching the screen, waiting for the results to come out.

This condition is just as Niu Zhuren said; generally, surgery is not needed for treatment, so Dr. Merz does not require surgery.

Most cases of omental infarction are discovered during emergency exploratory surgery; since it is already opened, if it can be conveniently removed, surgical resection of the infarcted omental tissue is generally advocated.

Surgical resection of the infarcted lesion can rapidly improve the Patient's symptoms and signs, leading to faster recovery and a shorter course of the disease.

Laparoscopic resection of the infarcted local greater omentum can more effectively reduce postoperative complications such as pelvic and abdominal abscesses, Penfuqiang Nianlian, and Intestinal Obstruction.

For Patients with milder conditions, after conservative treatment, the local inflammatory response can gradually subside, and the greater omentum gradually retracts and undergoes fibrosis; most Patients basically recover within two weeks, while some symptoms and signs may persist for several weeks. Follow-up CT and Ultrasound can show the mass gradually shrinking with clearer boundaries.

As for how Dr. Merz's omental infarction came about, Ji Xiang has absolutely no idea.

Perhaps it was caused by his overeating, or perhaps it was caused by a bad mood leading to increased blood pressure; who knows.

Ji Xiang does not care how Dr. Merz's illness came about, as long as surgery is not required.

If surgery were needed, according to the System Operating Room NPC, it wouldn't just be a matter of resection; there would be very troublesome follow-up issues.

However, Dr. Merz's luck seems to be good; after the Enhanced CT images came out, Ji Xiang breathed a sigh of relief.

It is the same as what was displayed in the System Operating Room: surgery is not needed, conservative treatment will suffice.

When told this result, Dr. Merz was still very worried and requested the imaging data to be sent back to Massachusetts General Hospital.

Ji Xiang felt the vast difference in Dr. Merz's attitude before and after very clearly.

But it is also normal; Ji Xiang has been a Patient many times.

"Dr. Merz, have your emotions fluctuated greatly recently?" Ji Xiang asked on the way to take Dr. Merz back.

"..." Dr. Merz was stunned for a moment.

He thought about how the symptoms of abdominal pain appeared after he learned that Wembanyama had received a call from Zhenni Basi and would likely go to the Lakers.

How did Ji Xiang know?!

"Although there is no confirmed cause for primary omental infarction, many Patients have it caused by blood pressure fluctuations. What I find strange is that, theoretically, your blood pressure regulation should be excellent, so why would it suddenly fluctuate?"

Dr. Merz felt as if the Great Demon King had knocked him to the ground and was continuously slapping his face, asking him if he knew he was wrong while slapping him.

F***!!!

(End of this chapter)