Chapter 76: Not a Problem
Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation
Lower Groove Clinic was opened for business at nine o’clock in the morning.
The earliest to come to the clinic were the clinic’s regular patients, especially the old folks who came for the Xuesaitong injection [1] or to get Red Sage[2]. They would slowly head over to the clinic for registration after they had their breakfast.
The excellent nurse, Juan Zi used her fifty-five-pound left hand to pat the arm of an old patient skillfully. She then used her right hand, which weighed sixty-one pounds to insert a needle into the patient’s blood vein. Soon after, she helped the old man set up his intravenous drip, and adjusted the speed of the drip to an appropriate pace. She then revealed a smile. The entire process had gone very smoothly.
The regular patients would come over for transfusions once in a while. Once they visited the clinic many times, Juan Zi would know where to insert the needle and whose blood veins were fragile like the back of her hand.
In about half an hour, around seven to eight regular patients sat in the central room of the main space in the clinic.
The time required for the elderly to receive their transfusions was long. Many of them would plan their time to visit the clinic, so that they could have their lunch once they were done. They would lie on the spots where they thought they could admire a great view. Some of them would look at the sky, some of them talked among themselves, while some of them read. The ones who read would be the first to yawn…
Doctor Xiong had filled up all the forms that needed to be filled. He sat back behind a small square table by the front door of the central room and opened a newspaper before he started to read it seriously. Sometimes, patients would ask him questions. He answered, but his eyes never left the paper.
Truth be told, the regular patients’ illnesses were long-standing illnesses. The questions they always asked did not sound new. When Doctor Xiong answered their questions, he practically did not need to think.
On the occasion that the patients’ questions required Doctor Xiong to think, the outcome of his thinking would always be, “Please have a checkup at the hospital.”
Of course, he would provide guidance about which department the patients should go to, just like those foreign general practitioners.
*Ring.*
The crystal-clear sound of a bell was heard echoing in the alley.
Ling Jiezhou, who was on the first floor, was drinking tea. He immediately smiled and said, “Golden Deer’s van is coming over.”
“So that’s their company’s ambulance?” Ling Ran was a little surprised and asked.
Ling Jiezhou started laughing. “Of course not. That’s Doctor Miao’s bicycle. He always comes at this time after driving through heavy traffic.”
After he realized that his words were vague, Ling Jiezhou started to speaking as he counted with his fingers, “Golden Deer’s ambulance will send the first batch of patients at around ten o’clock in the morning the earliest every day. Doctor Miao will always call before he comes over. If Golden Deer sends people over, Doctor Miao will inform our clinic much earlier. Otherwise, he’ll wait until it’s noon or the afternoon before he gets over here.”
Ling Jiezhou lamented, “Doctor Miao’s life is difficult. He needs to work overtime at the Emergency Department of Yue Hua Hospital at night while he has to do part time in our clinic. He rides back and forth on his bicycle, and he only agreed to two hundred RMB after I allowed him to have flexible working hours.”
“Doesn’t Doctor Miao have a formal job?”
“According to rumors, something happened. So he can only do part time jobs out here for now,” Ling Jiezhou chuckled and said, “Doctor Miao’s good in using absorbable sutures. And he’s good at talking. He’s earned us quite a sum of money during this period of time… Unfortunately, young Ran, you can’t help him. Otherwise, I can talk to Doctor Miao and have you two split his salary. Then I can just give him 120 RMB…”
Ling Jiezhou spoke while he glanced at Ling Ran through the corner of his eyes.
Ling Ran was not moved by the idea at all. If he needed money, he could just ask for it from his mother. He never had the need to work under his father for that.
After he pondered over it for a while, Ling Ran said, “I can help with the physical examinations.”
Ling Ran had planned to go to the hospital in the morning to perform physical examinations on the patients in the ward. Since he was relieved of his duty for the day, he may as well perform some physical examinations in his family’s clinic.
The hospital had Lu Wenbin and other resident doctors to do the ward rounds. The hospital would not summon Ling Ran if there was no urgent matter. Based on that alone, aside from the fact that he still needed to be on duty, Ling Ran was living the life of a second-string doctor.
Ling Jiezhou widened his eyes the moment he heard “physical examination”. So he asked, “Did you learn some techniques from the pharmaceutical sales representative?”
While she brewed tea, Tao Ping’s hands quivered. She looked at her son in panic.
Ling Ran asked, “What techniques?”
“Techniques to give prescriptions, of course. You’ll first do a physical examination, then prescribe a lot of medication to the patient after that. Has he taught you how to do that?” Ling Jiezhou’s eyes sparkled brighter the more he spoke. He was practically itching to turn into the cashier of a big hospital.
Ling Ran shook his head in resignation, stood up, and said, “I only know how to perform physical examinations for now. I don’t know how to prescribe medication yet.”
“You can’t charge patients for physical examinations. Patients nowadays expect to get something after they make their payment. If you receive money and don’t give them something, they’ll feel as if they’ve wasted their money.” Ling Jiezhou sounded as if he was giving earnest advice with good intentions in his heart. He continued. “We’re conducting a business in the neighborhood, so we can’t be too greedy.”
“Then we don’t charge for physical examinations. That should do it.” Ling Ran went downstairs after he said these words.
Ling Jiezhou quickly followed him down while he continued to chatter. “If you don’t charge them, then what should we do if everyone comes here for physical examinations every single day? If we refuse to do physical examinations for them, they won’t be happy. If the results of the physical examinations reveal problems, they won’t believe you as well. They’ll think that you’re just trying to sell them medication…”
“You wanted me to write prescriptions just now.”
“That’s why… the most important thing between a doctor and a patient is to build a relationship based on trust. Just look at our family clinic. Many patients who come to our clinic never ask about the price of the medication prescribed to them. Everyone knows that I don’t take advantage on them when it comes to money… Oh, Doctor Miao has arrived… Allow me to introduce to you my son, Ling Ran. He’s a student from Yun Hua Medical Institute and is currently doing his internship in Yun Hua Hospital.”
Ling Jiezhou dragged Ling Ran up to Doctor Miao, who just came in through the front door.
Doctor Miao was roughly forty years old. He had fish eyes and a rosacea-ridden[3] nose. He looked rather worn out. He was wearing a white coat over a white shirt. He stood straight, but it made him look like he had ankylosing spondylitis[4]…
“Miao Tansheng.” Doctor Miao shook Ling Ran’s hands indifferently. He was merely a part-time doctor. It was not necessary for him to pay close attention on the boss’ son, especially a boss who only paid him two hundred RMB a day.
As they were talking to each other, the sound of an ambulance’s siren traveled into their ears.
“A reinforcing bar at the construction site fell and smashed the patient’s head. I’ll go and receive the patient.” As Ling Jiezhou, Doctor Miao had called earlier to learn of the situation. After he gave a brief explanation, he turned around and walked out the door.
Ling Ran went up to the front door and said, “Doctor Xiong, I want to practice performing physical examinations. Let me assist you a little.”
Doctor Xiong was the regular doctor in Lower Groove Clinic. He would only write some prescriptions on regular days. He seldom performed debridement and suturing as well. Whenever he encountered such a situation in the past, he would usually refer the patients with more troublesome cases to other places.
When he heard that Ling Ran wanted to practice his skills, Doctor Xiong put down his newspaper and stood up on his feet instantly. He looked at Ling Jiezhou and said, “No deduction in my pay.”
Ling Jiezhou opened and closed his mouth in a flabbergasted manner. Then, he turned around and left, as though he was just passing by.
“Oh, Ling Ran, you didn’t go to work today?” It did not take long before an old lady came over to the clinic along with her little granddaughter. She said, “Doctor Xiong, come have a look. She has been coughing since she woke up. I’m worried that she has a cold again.”
“Let Doctor Ling help you look at her first.” Doctor Xiong crossed his legs and sat behind the medicine counter.
“Come, take a seat here.” Ling Ran patted the chair in front of him and asked, “What’s your name?”
That was the standard procedure of performing a physical examination.
A physical examination was an examination performed by a person on another person using only simple machines. Therefore, physical examinations were very particular when it came to politeness, the attitude of the doctor, and also the doctor’s appearance.
Back in the medical institute, when he had to take his exam on how to perform physical examinations, he was definitely tested on how to treat the patients as kings and whether he had a high sense of responsibility or good medical ethics.
Ling Ran had even practiced smiling in front of the mirror for that.
The little girl who was held by her grandmother seemed to be around seven to eight years old. She appeared to be a little unwilling to see a doctor. However, when she saw Ling Ran’s face, her attitude took a strange turn. She obediently sat down on the chair across Ling Ran with both of her legs closed together like she was in a class. She spoke in a soft voice, “My name is Song Xue.”
“Alright, little Song Xue, I’ll help you look at your tonsils. Come, do it like me. Ah…” Ling Ran took out a tongue depressor and removed the plastic package around it. At the same time, he taught the little girl what to do.
Song Xue repeated after him and opened her mouth.
Ling Ran then used the tongue depressor to swiftly press her tongue. At the same time, he used a flashlight to shine into her mouth. After he pulled his hands back, he said, “Her tonsils are inflamed. Doctor Xiong, please write her a prescription.”
The grandmother had gone there with the intention to get medication. Furthermore, when she heard that Doctor Xiong was the one who would write the prescription, she only responded with a simple hum of acknowledgement.
From her point of view, getting the prescription was obviously more important than the physical examination.
Ling Ran observed her. While he waited for Doctor Xiong to finish writing the prescription, Ling Ran said, “I saw you rubbing your neck a couple of times. Do you feel pain in the vertebrae of your neck?”
“That’s right. I don’t know if it’s because I fluffed my pillow too high last night before I slept.”
“Allow me to help you check it.” Ling Ran’s desire to practice was growing.
The grandmother hesitated for a moment. Then she sat in front of Ling Ran.
“I’ll help you do a neck examination first… I’ll touch the vein in your neck…” After he observed her for a brief moment, Ling Ran stood behind the old lady and did the examination while he spoke.
“Nothing’s wrong with your lymph node. Your thyroid’s fine as well. You have a little high blood pressure?” Ling Ran was performing his first case of neck examination on his patient attentively. His Specialist Level Physical Examination skill had been activated. He could acquire a great amount of information.
“My blood pressure hasn’t been too good over the past few days. My reading yesterday was 130/90.” The old lady had her neck seized by Ling Ran. She sounded like she was speaking with a lisp.
Ling Ran said, “Let’s have a check on the active range of your neck then… Shrug your shoulders a little. We’ll look at your accessory nerve… Hmm… no problem as well…”
As the old lady listened to Ling Ran, for some reason, she felt happy.
The young man’s voice was nice to begin with, but most importantly, he would say “no problem” after he was done with each examination. Naturally, it made her feel relieved.
She was old. The thing that she wanted to hear the most at her age would be “no problem”.
“Your main problem is your high blood pressure.” After Ling Ran was done with the neck examination, he smiled politely and gave his conclusion.
“In that case, can you change the prescription of the medication for me?” the old lady asked in a probing manner.
“We can change the medication for your systolic pressure since it’s 130. Your diastolic pressure is 90, which is a little high, but you don’t need to change your prescription for that. Just take care of your recent diet and everything will be fine…” Ling Ran was very familiar with regular illnesses such as high blood pressure. So he just advised her according to the guidelines for high blood pressure.
Before the old lady could ask more questions, an old man forced his way through and said, “Give me a physical examination as well.”
“Where are you feeling your discomfort?” Ling Ran smiled politely. A full-body physical examination required quite an amount of energy and time, and it was not absolutely necessary. Hence, it was very important to ask the patient about their medical history and their complaints first.
“I have minor tracheitis[5]. My lungs aren’t good as well. It’s a chronic illness. Whenever the weather turns cold, I suffer. And whenever the weather turns dry, I suffer too…” the old man explained in detail.
Ling Ran nodded as he listened to the old man. He also did a lung percussion[6] and listened to the sound of the man’s lungs.
“The sound on the outside is clear. The clearness of the sound isn’t bad too. There’s no problem with your lungs. If you’re worried, let’s take a look at the expansion of your chest.” Ling Ran stood up and went behind the old man.
The moment the old man heard that there was no problem with his lungs, he revealed a smile on his face and voiced his relief repeatedly. Soon after, he followed Ling Ran’s instructions and took deep breaths…
In just a moment, a few regular patients called Ling Ran to give them physical examinations.
When the new elderly patients saw this, they decided not to get a transfusion at the moment. They just sat down and waited for Ling Ran to give them physical examinations.
Ling Ran had a polite smile on his face, making him appear friendly but also a little awe-inspiring. Everyone was fond of him. He would always be able to tell everyone about their illnesses accurately. Even though they were long-standing illnesses, everyone still wanted to get a confirmation.
Doctor Xiong watched this indifferently. He was happy that someone had taken over his responsibility to chat with others.
After debriding and suturing the patient, Doctor Miao also narrowed his eyes, observing the scene after he came into the room. No one knew what he had on his mind.
At some unknown point of time, a few girls who were just walking by arrived at the clinic’s reception desk quietly, and queued up.
Doctor Xiong’s eyes became focused, even though they remained on the newspaper. He put down his newspaper and stood up instantly to speak to Ling Ran. “Young Ling, do you want to take a break? I will take it from here for you for a little while.”
“Sure.” Ling Ran had just completed eighteen physical examinations. Once he checked with the system, he received a verification that his ranking in Yun Hua City in terms of physical examinations had increased by one. He was currently ranked 1,127. He was contented. He was also thinking about stopping to take a break.
The few girls who were sitting before the clinic’s reception desk panicked for about two seconds. Then, the girl who was sitting at the frontmost position of the group suddenly stood up and said, “I forgot to take my clothes in.”
“Oh, right. It’s about time to take the clothes in.”
“Let’s go back quickly.”
After their completely insincere conversation, the reception desk became peaceful again.
Doctor Xiong quietly opened his newspaper, then had a cup of light tea with some goji berries.
Note:
1. Xuesaitong injection: A Chinese medicine that has the function to promote blood circulation to dispel blood stasis. Usually comes in pill form or injections.
2. Red Sage: A perennial plant in the genus Salvia, highly valued for its roots in traditional Chinese medicine
3. Rosacea: A long-term skin condition that typically affects the face. It results in redness, pimples, swelling, and small and superficial dilated blood vessels
4. Ankylosing spondylitis (AS): A type of arthritis in which there is long term inflammation of the joints of the spine.
5. Tracheitis: An inflammation of the trachea.
6. Lung Percussion: An assessment technique which produces sounds by the examiner tapping on the patient’s chest wall.
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