Chapter 76: Absolutely No Intentions

Chapter 76: Chapter 76: Absolutely No Intentions

Yu Zhiming worked straight through until 6:30 in the evening, only then finishing his diagnosis of the last patient assigned to him.

Fifty patients!

Over the course of the entire day, Yu Zhiming had seen a total of fifty patients. He felt completely drained.

This profound exhaustion wasn’t physical; it was primarily mental.

He had to maintain intense focus during every auscultation and percussion. On top of that, he had to rack his brain, applying everything he knew to meticulously corroborate each patient’s symptoms.

His goal was to make his diagnoses as accurate and error-free as possible.

It wasn’t like the clinic at the county hospital, where most patients came in with minor ailments like headaches and fevers that didn’t require much mental effort.

But the patients here were different. Yu Zhiming needed to be meticulous with his examinations, terrified that a single oversight could lead to a misdiagnosis or a missed diagnosis.

After a full day of such high-intensity, continuous work, Yu Zhiming was so tired he felt stupid.

Even though he had worked so hard, even starting nearly half an hour early after lunch, he had barely managed to diagnose fifty patients in one day.

Yu Zhiming learned from the young nurse, Wang Li.

The other clinics had seen patient loads of eighty-plus, ninety-plus, and some even over a hundred today.

His patient volume put him at the bottom of the pack.

’But the quality of my work is high,’ Yu Zhiming told himself, giving himself a pep talk after the slight blow to his confidence.

He couldn’t claim his diagnoses were completely free of errors or omissions, but he was confident his error rate would be very low.

Doctors who saw over a hundred patients a day also had to spend a good deal of time reviewing the test results or imaging scans that clinic patients had just completed.

Sometimes, the same patient would require more than one follow-up review.

In that case, did that mean the average time spent on each patient was only three to five minutes?

With such a short amount of time for diagnosis, unless a doctor had eagle eyes, superb medical skills, an unwavering sense of responsibility, and intense focus, the probability of errors and omissions wouldn’t be low.

The internet was full of occasional stories about ludicrous misdiagnoses from major hospitals...

As someone on the inside, Yu Zhiming understood, but he also felt a sense of helplessness. Sometimes, these kinds of problems were unavoidable.

Doctors are human, not machines.

It’s difficult to expect a doctor to maintain peak mental and physical focus throughout an entire day while facing an endless parade of patients.

Quantity and quality were forever at odds...

Among the patients Yu Zhiming saw that afternoon, he had transferred another one to the center.

The patient was a sixteen-year-old boy whose symptom was hypersomnia—he could fall asleep anytime, anywhere.

The boy would drift off unconsciously not only during class but could even doze off in the middle of a meal if he wasn’t careful.

This ability to fall asleep so quickly made Yu Zhiming, an insomniac, a little envious.

For the boy, however, this hypersomnia was seriously affecting his studies, especially since he would be a sophomore in high school after the summer break.

Yu Zhiming determined his condition was a neurological issue, which happened to fall under Teacher Qi’s area of treatment.

So, Yu Zhiming took the initiative to admit the boy to the center...

Dragging his heavy body back to the center’s main office, he was surprised to find that Teacher Qi hadn’t left yet.

Yu Zhiming knocked and entered the director’s office, where he saw Teacher Qi looking through a stack of cardiac examination files.

"Teacher, is that for the patient from this morning?"

"Has it been confirmed?"

Qi Yue nodded. "This afternoon, Doctor Wang and I performed a stress test on him."

"We had him do high-intensity, overload exercise. Not even two or three minutes in, we noticed signs of ventricular fibrillation and ventricular tachycardia."

Qi Yue remarked with a sigh, "If we hadn’t stopped him immediately and started treatment, he probably would have gone into cardiac arrest right then and there."

"His condition is indeed very serious."

Yu Zhiming let out an "oh" and asked with concern, "The cause?"

Qi Yue shook his head. "It’s difficult to determine the exact cause."

"We’ve autopsied the hearts of more than one cardiac arrest victim. We found that several of them had perfectly healthy hearts, but they just stopped beating for no apparent reason."

"Many cases of sudden cardiac death are actually caused by systemic issues. The heart is just the organ where the stress manifests."

Qi Yue said jokingly, "It’s like the brain receives alarm signals from all over the body, saying it’s too tired and needs a break."

"The brain processes this information, decides to go on strike, and then notifies the heart, its power source."

"’You can knock off now.’"

Yu Zhiming chuckled a few times. "So if you can’t find the exact cause, the only options are maintenance and prevention?"

Qi Yue nodded. "First, he needs to adjust his work and lifestyle, reduce stress and tension—basically, live a different way."

"Second is to implant an ICD, just in case."

An ICD is a small cardiac pacemaker. Its professional name is Implantable Cardioverter-Defibrillator.

Its working principle is similar to what you see in TV shows and movies: a medical worker uses a defibrillator, places the brick-sized paddles on the patient’s chest, and with a sudden jolt, delivers a life-saving electric shock.

An ICD is small and can be implanted under the skin of the patient’s chest or abdomen.

Its electrode leads, placed inside the heart, can automatically detect when a patient experiences ventricular fibrillation or ventricular tachycardia, at which point the pulse generator rapidly charges and delivers a jolt of electrical energy.

The entire process takes only about 15 seconds, allowing it to promptly terminate the ventricular fibrillation and save the patient’s life.

Its advantages are that the success rate of the electric shock is nearly 100%, and it can also monitor the patient’s heart rate around the clock.

If the patient develops a fatal arrhythmia, it can automatically identify it and administer discharge therapy, restoring the heart to a normal rhythm.

Another question occurred to Yu Zhiming, and he asked with concern, "Teacher, what’s the total cost for this ICD implantation?"

Qi Yue replied casually, "Using the best ICD and a minimally invasive implantation surgery, the total cost is around one hundred fifty thousand yuan."

"That’s really not cheap," Yu Zhiming sighed softly.

Qi Yue chuckled. "But this is something that can save a life in a critical moment. Besides, one implantation lasts for ten years. That averages out to fifteen thousand a year, which isn’t that high."

After a brief pause, Qi Yue changed the subject. "That boy who was transferred over this afternoon—it’s not hypersomnia, it’s narcolepsy."

"It’s a genetic disorder that causes the hypothalamus to secrete an excess of neuropeptides. This causes the patient’s sleep-wake switch to malfunction, resulting in irresistible, short bursts of sleep."

"This disease is incurable; it can only be managed."

When Yu Zhiming heard it was a genetic disorder, he knew it would be difficult to cure.

He listened as Teacher Qi continued, "I’ve treated dozens of cases of this disease, so I have quite a bit of experience with it."

"We’ll observe him for two days, run a few medication trials, have the boy practice exercises to resist sleep with willpower, and then with long-term use of the medication I prescribe, he should be able to maintain a relatively normal life."

Yu Zhiming said with deep feeling, "A disease like that will cause so many inconveniences in his life and work."

"Driving is out of the question, at least. And I can’t think of any way to turn this disadvantage into an advantage."

Qi Yue nodded. "Not just driving. He won’t be able to do any high-altitude work or other hazardous jobs."

A thought suddenly struck Yu Zhiming. "Teacher, is there a device similar to an ICD for this?" he asked.

"When a sleep attack occurs, it could give him an electric shock and instantly make him wide awake."

Qi Yue was slightly taken aback. "I haven’t seen any such device."

He pondered for a moment. "Narcolepsy may be a rare disease, but given our country’s population, there are probably six or seven hundred thousand patients. The number of new cases each year isn’t small, either."

"If there were such a device..."

Qi Yue mused, "I could ask some domestic medical equipment companies if anything like this exists on the market, and if it has R&D potential."

"It might just be worth pursuing."

Qi Yue looked at Yu Zhiming, hesitated for a moment, and asked, "Zhiming, did you have lunch with Zhou Mo today?"

Yu Zhiming’s heart skipped a beat. He hurriedly explained, "She brought lunch specifically to thank me for her mother’s physical exam. I tried to refuse."

"But Zhou Mo was just too insistent..."

Qi Yue said, "Oh," and continued, "I know Zhou Mo is an outstanding young woman. It’s only natural that you might have some ideas about her."

"It’s just that, her mother has made it clear beforehand that she absolutely forbids Zhou Mo from dating a doctor..."

’If she doesn’t want her dating doctors, why let her work in a hospital? It’s a classic contradiction,’ Yu Zhiming thought.

Teacher Qi saying this was a dead giveaway; he was just using Zhou Mo’s mother as a shield.

Yu Zhiming knew how to take a hint and quickly stated his position.

"Teacher, you can rest completely assured. I have absolutely no designs on Zhou Mo."

"I’m focused on improving my medical skills. I absolutely will not consider my personal life for at least a year!"