Chapter 864: Dosage Shouldn’t Rigidly Follow Textbooks—A New Awareness

Chapter 864 -408: Dosage Shouldn’t Rigidly Follow Textbooks—A New Awareness

“Director Yan is an expert in emergency medicine, and I believe you’re the one who knows that child’s condition best. I only know some very basic information and would never dare to comment rashly. But speaking for myself, since the child developed problems after taking the medicine, I think it’s either a drug allergy or an overdose. For kids, the dosage is definitely different from adults’.”

Li Jingsheng laid out his own view.

Sodium valproate is a prescription drug; for People’s Pharmacy to sell this medicine directly to a patient is definitely wrong.

This drug is clinically a first-line medication for treating epileptic seizures and absence seizures.

Pediatrics also uses it to treat benign myoclonic epilepsy of infancy and infantile spasms.

Sometimes when Li Jingsheng encountered epilepsy patients, he really wanted to use this drug, but he was extremely cautious. He never dared to prescribe it.

His clinic didn’t stock this drug either.

A lot of things are like this: if nothing happens, then as the saying goes, if the common people don’t report it, the authorities don’t investigate.

But once something does happen, the problem suddenly becomes very serious.

Why did Fatty Zhang come to ask for Li Jingsheng’s help?

It certainly wasn’t just as simple as wanting Director Yan to do his best to treat that child.

Fatty Zhang is also in the trade; there’s no way he doesn’t understand how the hospital works.

He asked Li Jingsheng for this favor mainly because he wanted Director Yan to mediate, to put in a good word, and keep the family from making a big fuss.

Otherwise, if it really reached the higher regulatory authorities, the lightest penalty for his People’s Pharmacy would be suspension for rectification.

On top of that, he’d have to swallow a fine.

Both of them understood the rules behind all this; if anything, Fatty Zhang understood them even better.

They just didn’t spell it out.

After putting in a word and making the request, Li Jingsheng chatted with Director Yan for a couple more minutes and ended the call.

“Dr. Li, no matter how this turns out, you’ve just done me a huge favor. I, Fatty Zhang, will definitely remember it. I came in a hurry just now and didn’t bring any gifts. This little red envelope, please don’t despise it—just take it as two drinks on me.”

A big red envelope was pushed into Li Jingsheng’s hand.

Judging from the thickness, it probably wasn’t less than two thousand yuan.

Fatty Zhang was a perceptive man.

Just like Boss Zhao, when he asked someone for help, he never expected a free lunch. When it came to giving gifts, he was generous to a fault.

“Boss Zhang, this is just a small matter for me. We’re all trying to make a living on the same street; it’s only right to help each other out. If you insist on giving me this red envelope, you’re treating me like an outsider.”

Li Jingsheng refused to take the red envelope.

Two thousand yuan wasn’t a small sum, but a favor owed is worth more.

He hadn’t asked anything of Fatty Zhang yet, but forging a good relationship now meant that if Sunshine Clinic ever ran into trouble in the future, as long as Fatty Zhang knew how to handle people, he would be a solid supporter.

“That won’t do. You used your personal connections to help me put in a word; that doesn’t come cheap. This is just a small token of my appreciation. Please, Boss Li, take it.”

“Really, there’s no need. I still think there’s a lot of risk in this matter. If you can, you’d better hurry over and find a way to calm the family down—try to turn a big issue into a small one, and a small one into nothing. Although the child developed symptoms like coma and vomiting, in my opinion the problem shouldn’t be too serious. Very likely it’s just that the dose was too high. If you had explained things to the family beforehand, then they also bear some responsibility in this.”

“As long as you keep a good attitude and cover part of their losses, once the child’s condition improves after treatment, you’ll probably be able to shake hands and make peace.”

In Li Jingsheng’s view, this shouldn’t be too hard to handle.

Unless the family was particularly unreasonable—then there’d be nothing to be done.

“Alright! I’ll head straight to the hospital to see the child. I, Zhang, will never forget what you did for me today. In the future, if Boss Li needs anything, just say the word.”

With that, Fatty Zhang hurried off to the hospital to placate the family.

A little after seven in the evening, Fatty Zhang came in carrying two bottles of Moutai and a carton of He Tianxia cigarettes.

“Dr. Li, I really have to thank you for your help today! They’ve already identified the cause of the child’s illness—it was caused by an overdose. I’ve already apologized to the family and obtained their understanding. I’ll be covering the medical expenses and their lost wages.”

“After treatment, the child has already improved significantly.”

It was more or less what Li Jingsheng had guessed; sure enough, it was an overdose.

Normally, Fatty Zhang wasn’t exactly easy to reason with. The fact that he went straight to apologize to the family and voluntarily agreed to cover both medical expenses and lost wages showed that he must have been at fault.

“That’s good, that’s good. In future, when you’re selling medicines for children, you really have to be more careful. My clinic is most afraid of seeing infants or children under seven. It feels like you’re practically carrying your head in your hands just to earn those few yuan.”

All Li Jingsheng did was gently hint at it.

With adults, you should never think about persuading them too much.

If Fatty Zhang could afford to drive a Mercedes, his money clearly hadn’t come from a gentle breeze.

The fact that they were able to get the family’s understanding and defuse a major incident was a stroke of sheer luck.

“Exactly! In the first place, it was just that business is hard these days and money is even harder to make, so I thought I’d expand the range a little. Who knew I wouldn’t make any money and would instead get myself into such a mess. A stumble makes you wiser—after this, I’ll never sell these prescription drugs again.”

That was what Fatty Zhang said; whether he could actually stick to it was something only he knew.

“Dr. Li, when it comes to medical skill, I don’t think anyone on the entire Old Street of South City can compare with you. For this child who had the incident, I specifically asked for his weight and calculated the dose for him. Based on his weight, he could have taken eight to ten tablets, but the family only gave him five before he started vomiting and then lost consciousness. I’m a medical school graduate myself; I just couldn’t get into a big hospital back then, so I came back to take over the family business.”

“I clearly set the dose according to the textbook and the prescribing guidelines—and he only took half of what should have been within the safe range. How did it end up being an overdose?”

After hesitating for a while, Fatty Zhang decided to consult Li Jingsheng.

He wanted to see where the problem lay.

This incident had completely overturned his decades of experience selling medicine.

If he didn’t find out what went wrong, he’d still end up falling on his face next time he sold medicine.

Don’t underestimate these pharmacy owners or Pharmacists—their skills in pharmacodynamics and pharmacokinetics are often quite decent.

If Li Jingsheng hadn’t later leveled up both of his skills in prescriptions and medications several times, he might not even be as good as this Fatty Zhang.

“Boss Zhang, don’t praise me to death like that. On the Old Street of South City there are plenty of people whose medical skills are better than mine—Boss Zhao, Boss Ye, the doctors at the health service station, including you, Boss Zhang—you’re all my seniors. Your medical skills are far more superb than mine.

At most you could say that each trade has its own specialty, and everyone is good at different things, that’s all.

When it comes to medication, under normal circumstances you can calculate the dosage according to body weight. But for children, the elderly, and physically weak patients, you definitely can’t calculate dosage purely based on normal body weight.

For children taking sodium valproate, the safe dose is generally 20 mg/kg, and must not exceed 30 mg/kg at most.”

He would never dare acknowledge something as stupid as being called “the number one doctor on Old Street.”

Smart people keep a low profile and make money quietly.

Those who like to call themselves “number one” and pull gimmicks are usually fools.

All for some so?called vanity, only to stir up a body full of jealousy—that’s really not worth it.

“That’s right, I calculated the child’s dose at 20 mg/kg. That’s already a very conservative formula.”

Fatty Zhang said.

“That depends on the child’s physical condition. If the child had already taken some other drugs with a certain degree of liver toxicity beforehand, then no matter how small a dose you prescribe, he’s still going to have problems. Also, if the child originally has some underlying diseases or certain defects, then the so?called safe dose will no longer be safe.

There’s another special situation: if the patient has a special constitution, then even if you only prescribe one tablet, he still won’t be able to tolerate it.

Just like how some people can hold their liquor and never get drunk, while others keel over after just a sip—that has a lot to do with constitution as well.

Prescription drugs are inherently high?risk.

In future, when you encounter this kind of situation, Boss Zhang, you can adopt some more conservative methods.

For example, first prescribe a small dose for the patient to try; if there’s no problem, then have the patient continue taking it.

Of course, I understand how hard that is in practice. Everyone sells medicines by the box.

But there’s a saying: better safe than sorry. It’s fine to sell regular medicines by the box, but it’s best to be more cautious with prescription drugs.”

Li Jingsheng was genuinely and sincerely giving pointers to Fatty Zhang.

In the past, he thought peers were enemies and would definitely never play the bleeding?heart good guy.

Now that his clinic had grown bigger and stronger, his mindset, vision, and overall outlook had changed a lot when he looked at competitors like Fatty Zhang and Boss Zhao.

These people could no longer be his real opponents.

At the same time, he truly hoped the medical industry could develop in a healthier and healthier way.

When a tree stands out in the forest, the wind will surely destroy it.

If he alone dominated, he’d be like a solitary tree, and that was definitely not a good thing.

You still need some shorter shrubs around for contrast.

It’s like being a general—if you don’t have any soldiers under you, you’re just a lone commander, which is nothing at all.

On this street, having a healthy overall medical environment would be a big plus for his Sunshine Clinic as well.

To put it on a more sophisticated level, now that he had become the boss of Old Street of South City, what he had to worry about was no longer being crushed by Quick Recovery Clinic or People’s Pharmacy. Even if they got several times stronger, they still couldn’t shake the solid foundation of Sunshine Clinic.

Li Jingsheng and Sunshine Clinic had already built a deep base of public support in the south of the city, and even in Jiangli City.

What he had to do now was play the role of the big brother in the lead and maintain the entire “ecosystem” of Old Street of South City.

Just imagine: everyone is like fish in the same pond. He’d been eating well and growing fat, and now he was bigger than all the other fish.

The other fish could no longer beat him in a fight.

But if any one of those fish died or something happened, it would definitely affect the water quality of the whole pond.

And this big fish would suffer for it too.

“A single conversation with you is better than ten years of study. The guidance Boss Li gave me today is drug?use knowledge I could never learn from reading however many books. Thank you, Boss Li, for being so open?minded in advising a fellow practitioner like me. The fact that Sunshine Clinic has grown so big today clearly has its reasons. I, Zhang, freely admit that my level of thinking and awareness is far behind yours.”

After hearing Li Jingsheng’s guidance, Fatty Zhang showed a thoughtful expression.

He slowly digested the medication knowledge in it.

He also genuinely admired Li Jingsheng’s character.

After seeing Fatty Zhang off, Li Jingsheng also began thinking about the future direction of Sunshine Clinic’s development.

Long ago, his idea had simply been to make Sunshine Clinic bigger and stronger.

Now that it had really developed, he was starting to think about more concrete development paths.

The surgical business had always been growing, but was stuck under the cap of Level?I and Level?II procedures. It was very hard to move into more advanced areas.

This was certainly unfavorable for Sunshine Clinic’s future development.

According to his vision, he wanted to build a first?class medical team covering three major areas: internal medicine, nursing, and surgery.

And more specifically, there would be even finer subdivisions under each.

Right now, they hadn’t even properly set up this main framework, so there was no way to push forward with the details below.