Chapter 2779: with translation of chapter title

They didn't waste time changing clothes, and soon the three left the changing room, walking toward the CT room while chatting.

"In the future, aside from the capital, Modu, Yangcheng, Pengcheng, and provincial capitals, the number of experienced doctors in large tertiary hospitals will keep dwindling, as they all move to private hospitals," Director Kong said.

Zheng Ren and Su Yun listened quietly.

"Gu Xiao Ran will eventually have to take that step, and I think it's a good thing for him."

"Director, how many years do you estimate it will take to reach that point you mentioned?"

"I used to think it would happen in twenty years, but now it's coming faster and faster. Many public hospitals lack medical insurance quotas... this sort of thing can't be discussed openly, but it's quite common in local areas, you should know."

"Hai Cheng... still okay." Zheng Renye sighed.

"That's because you're at Haicheng First Hospital, Boss Zheng—you usually don't like to chat with people. Other hospitals in Hai Cheng face this issue. Doctors just work to support their families; if there's no work, what can they do? Go to private hospitals. There they use commercial insurance, with few restrictions," Su Yun said.

Zheng Ren knew Director Kong was speaking the truth; he was just a doctor with little recourse. Doctors like Gu Xiao Ran, who come from third- or fourth-tier cities, will eventually have to leave home for big-city public hospitals or private ones.

Regardless of his willingness, an individual is insignificant before such a trend—comparing it to a mantis trying to stop a chariot is not an exaggeration.

"A few days ago, someone approached Zhao Wenhua," Director Kong continued.

"Huh?"

"A newly established private hospital has also poached people from the Medical University Affiliated Hospital. They're mostly dissatisfied team-leading professors; doctors like Zhao Wenhua are still rare."

Zheng Ren understood the reasoning, nodding slightly. He guessed Director Kong knew about this because Zhao Wenhua had gone to profess loyalty and talked with him.

Going to private hospitals is the future trend, not something human power can change. Zheng Ren, who has worked in public hospitals since starting his career, found it hard to accept at first, but facts won't shift based on whether he accepts them or not.

Following Director Kong's steps, the three arrived at the CT room. As soon as they entered, they saw Gao Jie wearing a white coat over an isolation gown, without having changed her clothes.

She and an emergency department doctor were pushing a stretcher back; Zheng Ren glanced at the system panel, which clearly read—acute liver injury, acute kidney injury, acute kidney failure.

Isn't it just vomiting and diarrhea?

Zheng Ren had no time to think; he immediately stepped forward to help.

"Gao Jie, how did your brother-in-law end up like this?" Zheng Ren asked.

"He was fine yesterday." Gao Jie said with a mournful face: "He started having diarrhea in the middle of the night, took two piperazine tablets, and by this morning it got worse. He insisted on going to work, and his coworkers said he almost fainted in the restroom."

His liver and kidneys have failed—could it really be just from almost fainting in the restroom? Zheng Ren thought to himself.

But in normal life, where would liver and kidney failure come from? Zheng Ren glanced at Gao Jie; her system panel showed a faint red glow but no diagnosis, indicating she was in a sub-health state rather than actually ill.

It probably isn't from food; if it were, the couple would have eaten together.

Seeing that Gao Jie's relationship with her partner seemed normal, Zheng Ren didn't dwell on it. So the remaining possibility was drug-induced liver and kidney abnormality; he immediately asked, "What medicine has your brother-in-law been taking lately?"

"Blood pressure medication, sugar-lowering drugs—he's taken them for years with no problems," Gao Jie replied.

"What medicine did he take for the diarrhea yesterday?"

"Piperazine, just two tablets—I watched him take them."

Piperazine is a quinolone antibiotic that works by acting on bacterial DNA gyrase, interfering with bacterial DNA synthesis and causing bacterial death. It's effective against Gram-negative bacteria and is commonly taken for diarrhea.

This drug is mainly excreted unchanged by the kidneys; within 24 hours after administration, 58%–68% of the dose is eliminated in urine, about 20% in feces, with a small amount metabolized in the body.

Zheng Ren didn't believe that two piperazine tablets could cause liver and kidney damage.

"Have you taken it before?" Although he doubted it, Zheng Ren asked cautiously, fearing a rare allergic reaction; even if the system panel showed no allergy alert, some biochemical reactions couldn't be ruled out.

"I've taken it before; I take it every time I have diarrhea, and it works well," Gao Jie replied.

After inquiring about other circumstances, Zheng Ren returned to the emergency observation room and went straight to find Zhou Litao.

"Boss Zheng, why are you here?" Zhou Litao said happily.

Zheng Ren saw the freckles on his face seeming to want to fly off; his spirits were still good, and he wasn't discouraged from again being the inpatient chief, so he breathed a sigh of relief.

"Gao Jie's partner is sick; I came to take a look." Zheng Ren said, "Have the emergency lab results come back?"

"Just got them back—acute liver and kidney injury. Transaminases are over 600, and creatinine is at 500." Zhou Litao brought Zheng Ren to the computer to view the lab sheet.

Just like the diagnosis for Big Pig Trotter, it's a severe acute injury.

He also glanced at the abdominal CT, seeing no abnormal lesions, no substantive changes, so he considered it still related to diet.

"Boss, could it be that Gao Jie is anxious and hiding something?" Su Yun said. "With such severe liver and kidney damage, we should still consider dietary factors—for example, drinking heavily then having strong tea to sober up; I've seen a similar case before."

"Hmm, let's ask Gao Jie again." Zheng Ren rested his chin on his hand, examined the images, made sure nothing was missed, and said in a low voice.

What Su Yun said is indeed a possibility—binge eating and drinking, heavy alcohol consumption, which affects liver function.

Drinking strong tea after alcohol, the theophylline in tea leaves can quickly affect the kidneys, producing a diuretic effect; at this point the alcohol hasn't been fully broken down and is excreted via the kidneys, exposing them to a large amount of ethanol, which damages kidney function.

Arriving at the emergency observation room door, Su Yun called Gao Jie out and asked, "Gao Jie, has your brother-in-law been drinking heavily these days?"

"No, he doesn't drink; even one bottle of beer is too much for him." Gao Jie, a little frightened, replied with a pale face.

"What about Chinese and Western medicines? Anything you haven't mentioned yet? For instance, during a gout flare, taking large amounts of nonsteroidal anti-inflammatory drugs?" Zheng Ren asked.

"No, his health is fine..." Gao Jie hesitated, then said: "I usually don't let him eat those random junk things. Um, I'll go ask—actually, now that you mention it, I'm not entirely sure."

Saying that, Gao Jie turned and went back to the ward.

Zheng Ren and Su Yun didn't follow her in; they waited at the doorway.

"It must be something he took; otherwise there's no way to explain it." Su Yun said.