Chapter 670: Teaching

Chapter 670: Chapter 670: Teaching

Li Xu’s gaze fell upon the patient’s right side. "Does it still hurt?" he asked.

The patient’s wife answered for him. "The pain isn’t so bad anymore, but he feels bloated and stuffy. He says it’s like there’s something growing in there, pressing on him, and it’s really uncomfortable. I was scared to death. I thought it was liver cancer, so I rushed him in for a full workup, but the results showed his liver, gallbladder, spleen, and pancreas are all perfectly fine. There was nothing there."

Upon hearing this, Wang Wenbo, who had been silent the entire time, let the corners of his mouth lift into a faint, amused smile.

Li Xu nodded as well, apparently having grasped the situation.

He said, "Give me your hand. I’m going to take your pulse."

The patient struggled to extend his hand and rest it on the Pulse Pillow.

Li Xu placed his three fingers on the patient’s wrist, quieting his mind and concentrating.

A moment later, he withdrew his hand. A hint of a smile returned to his face as he turned to the interns craning their necks to watch. "Come on, you all take a turn."

This was a habit of his.

As long as it wasn’t an acute or critical case, he was always happy to give the younger generation a chance for some hands-on experience.

"Thank you, Dean Li!"

The young men, as if they’d been handed a priceless treasure, lined up one by one to take the patient’s pulse.

However, after they had all taken their turn, their brows were knitted in concentration, their expressions even more baffled than before.

Li Xu watched them scratching their heads in confusion and began to lecture them in a serious, heartfelt tone. "Since you’ve chosen to study Traditional Chinese Medicine, you must practice every diagnostic skill until you’ve mastered it. You can’t just memorize textbooks in school, go through the motions, or press on a rubber tube a few times and call it a day."

"Pulse diagnosis is the soul of TCM. It’s not some mystical art, but it is by no means simple. You must seize every opportunity to practice and use your heart to feel the beating beneath your fingertips. With diligent study, you can grasp the basics within a year, no problem. But mastery? That takes a lifetime."

"As for how to find opportunities to practice... go ask Hu Qiming how he did it. I’ve already taught him the secret to that."

In the adjacent consultation room, Hu Qiming couldn’t help but sneeze upon hearing this.

Li Xu paused, then revealed the answer to the puzzle. "As for this patient’s pulse—it’s even."

"Huh?"

Now everyone was completely floored.

’An even pulse?’

’Isn’t that the pulse of a healthy person?’

"An even pulse means no illness." This was common knowledge in TCM!

Tang Changchun and the rest of the interns stared at Li Xu, completely baffled.

Their expressions seemed to say: ’Dean, you’re not joking, are you?’

’This guy is gasping for air, he’s wasted away to skin and bones, and he’s constantly losing his temper, yet you’re saying his pulse is even?’

’He’s not sick?’

’If he’s not sick, why did he come to the hospital?’

’For the life experience?’

The intern who was currently taking the patient’s pulse felt his hand tremble, and he almost thought he was checking the wrong person.

Seeing everyone’s reaction, Li Xu’s lips curved into a smirk as he added, "But it is slightly weak and not flowing smoothly!"

’Jeez!’

’Talk about a dramatic pause!’

The group of young interns nearly rolled their eyes.

’Is this guy’s condition contagious?’

’How did he infect Dean Li and make him talk with such dramatic pauses?’

’He’s going to give someone a heart attack!’

Without even turning his head, Li Xu called on someone by name. "Tang Changchun, you analyze it. What does a pulse that is ’even but slightly weak and not flowing smoothly,’ combined with the patient’s medical history, indicate?"

"Uh..."

Tang Changchun’s mind went blank, as if countless gears had ground to a halt in his brain. "Well... it’s..."

Hu Qiming, who was passing by, couldn’t help but laugh out loud when he saw this.

This was his favorite kind of scene to watch.

’He remembered going through the exact same thing with Li Xu back in the day, being questioned until he was tongue-tied and sweating bullets.’

’What goes around, comes around,’ he thought.

Tang Changchun hemmed and hawed for a good while but failed to come up with a coherent explanation.

Li Xu didn’t get angry. He simply asked faintly, "You don’t know?"

In truth, this pulse was not a typical pathological one. It didn’t have distinct characteristics like a Xian Vein or a slippery pulse.

It lay somewhere between normal and abnormal—it was very subtle.

Tang Changchun could only bite the bullet and try to speculate based on the clues Li Xu had just given. "Uh... a weak pulse indicates qi deficiency, and ’not flowing smoothly’ indicates qi stagnation. It should be... that the circulation of qi and blood is impeded? Perhaps because the qi deficiency leads to a lack of propulsive force..."

The answer was completely by-the-book, full of clichés. It was as good as saying nothing at all.

Li Xu remained noncommittal and turned to the others. "What about the rest of you? Do you have a different take?"

The other interns just looked at each other in dismay. They either stared at their own feet or averted their gazes, none of them able to offer a convincing explanation.

After all, the patient’s symptoms were too varied: a history of trauma, shortness of breath, emaciation, irritability, pain in his side... It seemed to touch upon many things, but none of them were classic presentations.

Wang Wenbo, sitting off to the side, still had that unruffled, detached air about him. He held his teacup and watched Li Xu with a placid expression, yet his eyes held a hint of anticipation, as if he were waiting to see how his junior would solve this puzzle.

...

Li Xu’s gaze swept across the room, lingering for a moment on each of the young faces before him. His tone was serious.

"This patient’s condition isn’t typical; you could even call it quite rare. These kinds of latent, ambiguous cases are the greatest test of a doctor’s fundamentals. You must remember this: as TCM practitioners, when you’re conducting an inquiry, you have to listen carefully to the patient’s description. Don’t let a single detail slip by, and more importantly, don’t fall into the trap of using Western medical diagnoses as a starting point."

"Did you all hear him just now? The patient repeatedly emphasized that he feels a ’sensation of a foreign object’ under his right side. He also often has trouble breathing, to the point that ’he can’t even finish half a sentence before he’s out of air’."

Li Xu stuck out a finger and jabbed his own right side emphatically. "Here. This is the key."

The interns looked at each other. They understood his words literally, but it still hadn’t clicked.

’His right side and his breathing... there are several layers of tissue separating those two areas. What direct connection could there be?’

Tang Changchun mustered his courage and asked, "Dean Li, we heard you on that point. But... isn’t that the liver region? The liver, gallbladder, spleen, pancreas, and kidneys are all in that area. What does that have to do with breathing? Isn’t respiration a matter for the lungs and kidneys?"

Li Xu didn’t answer directly. Instead, he posed a question back to him. "If you were the attending physician and this patient was sitting across from you right now, telling you he has discomfort here and is short of breath, what would you do? What’s your first step?"

"Uh..."

Tang Changchun hesitated, his gaze subconsciously drifting toward the lab request forms on the computer screen.

Li Xu encouraged him, "It’s okay, speak your mind. This is a teaching clinic. You won’t get points deducted for being wrong."

Tang Changchun scratched his head and said, a little sheepishly, "First... I’d have him get a liver function test to see if his transaminase levels are high. Then... get a CT or an ultrasound to rule out any lesions or inflammation in the liver..."

Toward the end, Tang Changchun’s voice grew quieter and quieter, as even he felt his confidence waning.

In any other general hospital dominated by Western medicine, his approach would be standard procedure—the gold standard, even.

But here, at the City Hospital of Traditional Chinese Medicine, in front of a pure TCM master like Li Xu, this "run tests before diagnosing" logic seemed a bit... out of place.

Tang Changchun’s face flushed with shame. He felt like he had disgraced Traditional Chinese Medicine.