Chapter 103: Visitors from Jingda Medical School

Chapter 103: Chapter 103: Visitors from Jingda Medical School

On Tuesday morning, Yu Zhiming arrived at Huashan Hospital, sporting dark circles under his eyes. He then took the patient admitted the previous afternoon with suspected ALS for diagnostic tests.

The fellow was a thirty-three-year-old homebody, standing at 1.7 meters tall and weighing 170 pounds.

He claimed to be a veteran gamer and made his living playing video games.

According to him, he could go for a month or two at a time without stepping outside, completely oblivious to the changing seasons.

If the muscle atrophy in his arm hadn’t started to seriously affect his gaming, he would have never bothered coming to the hospital for a check-up.

Seeing how the guy seemed perfectly content as long as he had his games, not caring one bit about his future, Yu Zhiming sighed to himself. ’A classic case of an optimistic, easily satisfied, "lie-flat" advocate.’

’Only someone with a mindset like this could go a month or two without ever stepping outside. Anyone with the slightest bit of drive would have gotten depressed...’

Diagnosing ALS, beyond clinical symptoms, primarily relies on electromyography (EMG), supplemented by imaging and neuropathology tests.

Yu Zhiming was busy the entire morning. Once the patient’s various test results were out, he cheerfully sought out Qi Yue.

"Professor, the test results are in. The main indicators don’t match; it’s not ALS."

Qi Yue took the stack of test results and images, glanced through them, and nodded. "You’re right, it’s not ALS."

He noticed Yu Zhiming’s beaming face and couldn’t help but smile as he asked, "You know, these results mean your initial diagnosis was wrong."

"You misdiagnosed him, so what’s there to be so happy about?"

Yu Zhiming chuckled. "I only wish my cancer premonitions would turn out to be wrong, too."

"If it had really been ALS, his life would have been over. I’m more than happy to be wrong about a diagnosis like that."

Qi Yue gave a small smile and asked, "Since the tests have ruled out ALS, what is your new diagnosis?"

"Professor, it’s Hirayama disease."

Hirayama disease, also known as juvenile muscular atrophy of the distal upper extremity, is a benign, self-limiting motor neuron disease.

Its clinical presentation is very similar to that of ALS.

Yu Zhiming pointed out the key indicators on the EMG and MRI scans one by one.

"Professor, his EMG shows neurogenic damage. Also, his cervical spine has a significant reverse curvature."

"I believe the patient’s prolonged poor posture caused the reverse curvature in his cervical spine. This is compressing the spinal cord, which then leads to ischemic and hypoxic damage to the motor neurons in the anterior horn."

"Based on these test indicators, combined with the patient’s clinical presentation, I am certain he has Hirayama disease."

"The treatment plan is an anterior cervical internal fixation surgery, followed by postoperative rehabilitation."

Qi Yue nodded in satisfaction. "This time, your diagnosis is correct, and the treatment plan is sound as well."

"You can ask Doctor Han to handle this minor surgery."

After a pause, Qi Yue offered some guidance. "Zhiming, you’re my student, but there’s no need to challenge yourself with difficult and unusual cases right from the start. You can begin by diagnosing and treating common illnesses and typical cases."

"You need to walk steadily before you can run."

Yu Zhiming knew his professor was admonishing him for being too rash and eager for results.

He admitted his error. "Professor, I know I was wrong. Next time I’m in the outpatient clinic, I’ll choose one or two more suitable patients."

Qi Yue continued to lecture, "Medical skill can’t be rushed. Experience is built one basic case at a time..."

Yu Zhiming’s obedient expression allowed Qi Yue to indulge his inner professor for a good long while.

Just as Qi Yue waved a hand to dismiss him, Yu Zhiming suddenly asked a question.

"Professor, is it true that Qiu Yi once wanted to be your student?"

Qi Yue grunted. "He came to see me the year he graduated."

"I turned him down, citing my policy of never accepting recent graduates who lack work experience."

Yu Zhiming said, "Oh," then asked, "I hear he’s about to finish his fellowship abroad and return."

"If he still has the same idea when he gets back, Professor, will you...?"

Qi Yue gave him a meaningful smile and countered, "Are you afraid I’ll accept him as a student, and your own position will be challenged?"

"Of course not!"

Yu Zhiming adopted a self-righteous expression. "I’d be thrilled if you took on more students, Professor. It would give me a chance to play the part of the senior disciple."

"Besides, I’m not afraid of a little competition."

"Having someone to compete with is motivating. It makes you run faster."

Qi Yue chuckled. "Even if he still wants to study under me, I won’t accept him."

"Why not?"

Yu Zhiming asked curiously, then added, "I heard a lot about Qiu Yi last night."

"He comes from a distinguished medical family, he’s a top student, considered the number one young doctor of his generation... I imagine plenty of people would be fighting to take on a student like that."

Yu Zhiming asked tentatively, "Professor, were you really never tempted by him?"

"Or... is there some other reason?"

Qi Yue said slowly, "For a young doctor who performs so exceptionally, it would be disingenuous of me to say I was never tempted."

"It’s just..."

Qi Yue paused, first issuing a warning. "I’m only telling you this. Don’t you go spreading it around."

Yu Zhiming immediately gave his assurance. "Professor, I can keep a secret. I absolutely won’t breathe a word of it."

Qi Yue said softly, "I’ve reviewed some of his case diagnoses and treatment plans. How should I put this...?"

"He has a tendency to take unnecessary risks and be flashy, when there are often much safer, more reliable treatment plans available."

"Consider his career path—a constant stream of accolades and news reports. It’s probably tied to his personality; he craves the spotlight."

"He... is not the type of student I’m looking for."

At nearly twelve noon, Yu Zhiming returned to the main office and saw a fruit basket on his desk.

Zhou Mo explained, "It’s from a patient, Zhang Zhe."

Zhang Zhe had undergone a minimally invasive ICD implantation last Friday. After three days of observation without any adverse reactions, he was cleared for discharge.

Another one of Yu Zhiming’s patients, Xu Feng, who’d had a severe herpes virus flare-up, had also been discharged last Friday to recuperate at a medical facility in his hometown.

Zhou Mo added, "He was discharged this morning."

"He couldn’t take all the fruit baskets his friends and colleagues brought him, so he left one for you to express his gratitude."

Yu Zhiming shot Zhou Mo a look. "You could have left that last part out."

"By saying that, you’ve seriously lowered my ’happiness score’ and diminished the sincerity of his gesture."

Zhou Mo giggled. "It’s perfectly normal. When patients are discharged, a lot of them give away the fruit and flowers they can’t take home to the doctors and nurses."

"I already checked, Dr. Yu. Out of all the baskets he gave away, yours is the best and most expensive-looking one."

"Look, it even has a fancy little durian."

Yu Zhiming waved a dismissive hand. "I don’t eat durian. If you like it, go ahead and take it."

Zhou Mo didn’t hesitate for a second. In addition to the durian, she also helped herself to several other pieces of fruit.

At 1:30 PM, Yu Zhiming received a "gift" from the general surgery department.

Two-thirds of a freshly excised stomach.

The patient’s stomach had been overrun by a tumor, and surgically removing most of it was a last resort to save their life.

The resected stomach was supposed to be treated as medical waste, but to Yu Zhiming, it was a priceless treasure.

He could perform all sorts of destructive tests on it, observing the pathological features of the stomach’s various sections post-canceration.

Yu Zhiming remained in the center’s lab, reveling in the joy of acquiring knowledge, until Zhou Mo interrupted him at five in the afternoon.

Zhou Mo covered her eyes, not daring to look at the various bits and pieces on the lab bench.

"Dr. Yu, the vice dean of Jingda Medical School is here."

"The director wants to see you in his office..."