What’s going on with Director Jin today?
Usually, despite his seemingly amiable smile, he never easily yields to any doctor’s opinion. When invited for a consultation, he either dodges the issue or is very assertive.
To unconditionally support a young doctor’s diagnosis like today is truly a first.
"Director Jin, checking the EEG and brain CT will waste quite a bit of time. The child’s condition has clearly improved after receiving cardiotonic treatment, indicating that it’s a heart issue. Shouldn’t we focus on the heart first, and only check the brain once the child’s condition stabilizes?"
Director Yan of the emergency department even feels that checking the brain is unnecessary.
It’s obviously a heart condition!
The low heart rate resulted in insufficient blood supply to the head, causing the coma, and that’s an indisputable fact.
"I think checking the heart can actually wait. It’s best to do an EEG right away, and test the cerebrospinal fluid, and if possible, first check serum antibodies. Have any of you considered that the child’s low heart rate may not be a recurrence of heart disease, but possibly a result of a brain problem causing the heart rate to slow down? In the surgical cases I’ve encountered, there’s a phenomenon where nerve problems lead to inadequate blood supply to the limbs, making the patient feel one side of their lower limb is cold. There’s also muscle atrophy on that side."
Li Jingsheng boldly expressed his viewpoint.
Nervous system issues can cause muscle atrophy and poor blood supply, which is practical clinical knowledge.
Experienced surgeons know this best.
Li Jingsheng has performed many surgeries over the past few months, accumulating more and more practical experience.
This is already showing results in this child’s diagnosis.
This is the result of improved overall skill.
"Although the child’s condition appears to have improved, if we don’t quickly investigate the brain cause, I believe the child’s condition could rapidly deteriorate. Therefore, I suggest immediately checking for brain inflammation, viral infection, or other such issues."
Li Jingsheng’s almost obsessive diagnostic style made Director Yan and Director Luo feel this young man is still too inexperienced.
Because Li Jingsheng initially determined that the child might have a viral infection.
Now, after the consultation, they all believe it’s more likely the child has a recurrence of rheumatic heart disease and subdural hematoma.
Not a viral infection.
"Xiaoli, we can’t rely solely on experience to make assumptions when diagnosing patients. You’re young, your clinical experience is actually quite limited, and being stubborn about your initial thoughts without considering evidence can easily lead to dead ends. I’ve been working in the emergency department for almost thirty years, yet I wouldn’t dare say my experience is that rich. Right now, I think it’s most important to first check the heart.
I don’t deny there may be a problem with the child’s brain.
But what was the result after the child received cardiotonic treatment? The child immediately regained consciousness from the coma. All signs showed improvement, and that’s undeniable."
Director Yan even changed the way he addressed him.
From Dr. Li to Xiaoli.


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