Chapter 876: [(876)] Surprised the Boss Chapter 876: [(876)] Surprised the Boss From his pocket, Nie Jiamin took out a pen and fixed his eyes on the medical record, his silent face clearly pondering something.
Teachers from overseas surely differ from those in China. Xie Wanying observed Teacher Nie as he corrected the outpatient medical records she had written. Unlike Teacher Tan, who almost never made changes to her writing. The outpatient medical records in China are relatively simple to begin with, displaying the main symptoms of the patients is sufficient.
It is widely acknowledged that she is meticulous in her work, often exceeding the requirements set by her teachers.
Unexpectedly, once Teacher Nie picked up his pen, he swiftly added a whole lot to what she had written. For example, she had noted in a child’s auscultation record that the respiratory sounds in the lower right lung were absent. Teacher Nie supplemented it with the child’s lung inspection, percussion, and palpation, requiring everything to be documented regardless of whether abnormalities were present or not.
Xie Wanying learned something new. She remembered a colleague once mentioning that overseas doctors pay a lot of attention to documentation because, once they face a lawsuit abroad, the legal scrutiny of documentation is stricter than at home. Documenting normal physical signs indicates that the doctor has conducted an examination in that aspect; failure to document might not prove that the doctor had actually checked, suggesting a possibility of irresponsible omission in diagnosis.
The situation is different domestically, mainly due to the larger number of patients. The number of patients a clinic doctor sees in a day domestically is unimaginable to doctors in developed countries overseas. The massive population in China naturally results in a vast number of patients.
It seemed that overseas doctors don’t have the concept of reducing each patient’s consultation time in order to see everyone.
Looking at a child, Nie Jiamin observed slowly, pondering thoroughly.
No doctor in China, no matter how slow, would dare to do it like him.
After all, he is a specialist hired by the hospital.
Xie Wanying did not dare to urge Teacher Nie to speed up, even just to remind him of the long queue of parents and children waiting behind.
Better to diagnose one child accurately than to hurriedly see a bunch and misdiagnose. Likely, that’s what Teacher Nie was thinking.
Finally, Nie Jiamin’s pen tapped down the preliminary diagnosis for the child: “Foreign body in the right bronchial tree pending investigation.”
Being not very fluent in Mandarin, Nie Jiamin allowed a student to communicate with the relatives. Regarding this, he seemed not too worried, for he had found the student’s earlier performance quite reassuring. However, meticulous as he was, he needed to ask further about the student’s thought process.
“When did you suspect that she might have a foreign object in her trachea?” Nie Jiamin asked with a steady gaze.
Xie Wanying recalled her thought process, “When the child arrived without coughing, and there was abnormality in her breathing, I began to suspect. Her thorax moved asymmetrically with her breathing, and when she coughed, the asymmetry became more pronounced as she bent toward the right side, indicating that the right lung was obstructed. The right bronchus divides into ten segments. The foreign object seems to be lodged between the number six and number five segment, it is likely small enough not to completely block the bronchus but moving further down to the smaller bronchi at segment seven and eight could be very dangerous.”
Her abrupt and detailed answer surprised Nie Jiamin internally: She could actually pinpoint where in the bronchial tree the foreign body was? That was almost as if her eyes or brain were like an x-ray or CT scanner capable of seeing through.
“The specific details would require the patient’s CT scan results,” Xie Wanying cautiously added.