Chapter 2230: 2153 Reading It Out as Written

Diagnosis is not made by one person but by a team; Li Lao realized this immediately.

Boss, only those who lead a project team with funded projects are called boss.

Of course, flattery and sucking up by junior doctors don't count.

Li Lao was somewhat confused; the boss of the rheumatology and immunology department had subordinates who arrogantly said that if they could overturn his diagnosis, they would throw the test results in his face.

I have never seen such a relationship before.

The research funding was secured by the boss; in the project team, the boss has absolute authority. How can the assistant be so arrogant? Could it be that they brought resources to join the team?

As the saying goes, one mountain cannot tolerate two tigers. If a project team has two bosses, who will make the final decision when a difficult problem arises?

Such project teams have existed before, but they don't last long.

Strange, Li Lao grew increasingly curious about what kind of project team this was.

The assistant, or perhaps the second boss, is actually so arrogant.

However, judging by his tone, his words were not malicious; they sounded more like a joke.

It seems to be a group of like-minded middle-aged professors who lead teams, gathered together to conduct a national-level research project, Li Lao speculated.

At this point, the director of the rheumatology and immunology department had finished reporting all test values and finally gave his diagnostic opinion—secondary antiphospholipid syndrome.

After ruling out all interference, he firmly diagnosed secondary antiphospholipid syndrome and systemic lupus erythematosus.

If not for the A4 paper in front of him, Li Lao would have applauded the rheumatology and immunology department director's brilliant reasoning.

The patient's condition is complex; he can pinpoint the main issue amidst the chaos, which demonstrates the technical level of the Medical University Affiliated Hospital.

Especially the final diagnosis, he stated it with absolute certainty, without any vague wording.

Yet, seeing the flamboyant handwriting on the A4 paper, Li Lao's feelings were somewhat complicated.

A project team, with an unknown "boss," actually diagnosed secondary antiphospholipid syndrome complicated by systemic lupus erythematosus based only on a few test reports and CT images.

This is somewhat miraculous.

【I estimate the boss won't be wrong; if you haven't yet diagnosed secondary antiphospholipid syndrome plus systemic lupus erythematosus, think about it and run the relevant tests.】

The words on the A4 paper were still as sharp and sarcastic as ever; although they didn't directly insult anyone, Li Lao could vaguely see a haughty middle-aged doctor with a look of disdain saying these things.

What a pity, he is the team-leading professor of rheumatology and immunology with his own project team; the chance of recruiting him under one's own supervision is almost nil.

Li Lao sighed.

After hearing the diagnosis of secondary antiphospholipid syndrome complicated by systemic lupus erythematosus, the endocrinology department director smiled. This matched his own judgment; after many tests, he finally turned his vague speculation into reality—this complex case truly tests one's ability.

Hearing Li Lao's sigh, the endocrinology department director paused, wondering if the diagnosis might be wrong.

"Li Lao, what's wrong?" she asked.

"Look." Li Lao handed over the paper he had finished reading.

The endocrinology department director stared for a moment, then flipped through the A4 paper.

The sharp, sarcastic tone made her very angry, yet she could find no fault in the entire document; the feeling was bottled up in her chest, unable to be released, leaving her deeply vexed.

As a doctor, cursing at someone's mother while pointing at their nose is the act of a shrew, devoid of any technical merit. Blaming the other's misdiagnosis while standing at the pinnacle of technology and looking down on everything—that is the true way.

Yet, looking at the diagnosis and reasoning written on the A4 paper, the endocrinology department director couldn't utter a word.

Their judgment is orderly and logical, although mixed with some speculation; even the doctor who wrote the disease analysis said this was his boss's insistence, hoping that if the judgment were wrong, they could smash him in the face with the correct diagnosis.

But their diagnosis is the same as that of the head of our hospital's rheumatology and immunology department—so what would you smash it with, and with what?

"The patient has high-titer antinuclear antibodies positive, ACA positive, low platelets, suspicious discoid rash, but because dsDNA-specific antibodies are negative, SLE is considered likely."

"Thus, the patient's diagnosis is basically clear: secondary antiphospholipid syndrome, SLE likely, bilateral adrenal vein thrombosis causing adrenal hematoma, leading to primary adrenal cortical insufficiency, finally resulting in adrenal crisis."

The rheumatology and immunology department director seemed to be reciting the words on the A4 paper verbatim; although not every character was exact, the general meaning was the same.

Li Lao stared at the characters on the paper, and a sense of absurd illusion arose in his mind.

She vaguely guessed that the medical team's technical level was not lower than that of the Medical University Affiliated Hospital, and might even be higher.

As a former chief of general internal medicine at the Medical University Affiliated Hospital, Li Lao felt pride in his heart, yet subconsciously he was unwilling to admit this.

But the diagnostic level of rheumatology and immunology is higher than that of the Medical University Affiliated Hospital—just which hospital is it?

【Well, finally, here's the treatment plan. Don't be impatient, and don't feel we're overstepping; the patient's swift recovery is most important. Putting on this big hat, doesn't it make your neck feel sore?】

Li Lao looked at the teasing words and could neither laugh nor cry.

【Warfarin anticoagulation, target INR 2–3, plus hydroxychloroquine to reduce aPI generation and inhibit platelet aggregation, prednisone 40 mg Qd plus methotrexate 10 mg Qw for immunosuppression.】

"I recommend using warfarin for anticoagulation, target INR 2–3. At the same time, add hydroxychloroquine to reduce aPI generation and inhibit platelet aggregation, prednisone 40 mg Qd plus methotrexate 10 mg Qw for immunosuppressive therapy." The rheumatology and immunology department director finally "read out" the treatment plan from the A4 paper exactly as written.

If he weren't at least ten meters away, Li Lao would have felt that he was actually reading the treatment plan on the A4 paper straight off without thinking.

This…

The endocrinology department director kept staring and also saw this passage on the A4 paper.

Eyes on the treatment plan, ears hearing the same treatment plan.

Does this count as a coincidence?

Li Lao and the endocrinology department director simultaneously imagined a scene from a TV drama: Zhuge Liang writing on his palm, and Zhou Yu, in unison, exchanging glances and laughing loudly.

But… the unknown medical team opposite, while lacking many necessary lab tests, still made these judgments.

Li Lao zoned out for the first time while participating in a general internal medicine ward round.

Receiving this patient in bed 2–8 from the endocrinology department, they would definitely be transferred to rheumatology and immunology; she didn't care about that, her mind kept recalling the smile left on the last page of the A4 paper after all the words were spoken.

The smile was completely opposite to the earlier sharp and sarcastic remarks; Li Lao did not think anyone was disparaging the Medical University Affiliated Hospital and mocking it outright.

She was very curious, even a bit anxious, wanting the internal medicine rounds to end quickly, she would go back and ask exactly which Hospital's Medical Team had this skill.