Chapter 873: A Bodhisattva’s Heart, Forced to Choose Between Two

“But this patient doesn’t have any symptoms like a fever!”

Zhong Hu found it quite unbelievable upon hearing that the patient had bone cancer, with the tumors at the joints having metastasized from the lungs.

When the lungs are affected, fever symptoms are most likely to occur.

Such as pneumonia.

“Moreover, the patient’s superficial lymph nodes aren’t enlarged at all. No abnormalities were found in the heart or abdomen. How can this turn into lung cancer?”

“Whether it’s lung cancer or not is not up to me to say. A scan will make it clear.”

Li Jingsheng confidently stated.

He knew Zhong Hu might still suspect the patient had osteoarthritis first.

Actually, the possibility of osteoarthritis can be directly ruled out.

Earlier, while performing the Bone Touching Skill on the patient, he noticed significant calcification in the soft tissue near the joints of the patient’s right hand’s index, middle, and thumb fingers.

Osteoarthritis is a degenerative joint disease.

It is most common in the elderly.

Moreover, joint pain symptoms are extremely apparent, especially when both knees are affected, leading to unbearable pain. This is most evident on rainy days or when the weather changes.

“We’ve already taken X-rays of the patient’s knee joints. Look, you can clearly see the bone spurs; bone hyperplasia is almost obvious at a glance. Based on my clinical experience, I believe the patient resembles osteoarthritis more.”

Zhong Hu is also an experienced orthopedic chief doctor, with competent skills and experience.

His diagnosis leans more towards osteoarthritis, naturally, he has his reasoning.

“But the patient’s joint problems mainly focus on the wrist and finger joints of both hands. Also, the red blood cell sedimentation rate test results show a noticeable increase. With osteoarthritis, this data doesn’t speed up. And one more thing, have you ever seen an osteoarthritis patient’s limbs elongate simultaneously?”

Li Jingsheng felt that diagnosing this case wasn’t as difficult as imagined.

The worst fear was that doctors might get themselves trapped.

While diagnosing, doctors can easily fall into a trap due to their rich clinical experience, by clinging to symptoms that match their initial diagnosis intentions.

“Alright, let me go talk to the patient first. The family and patient are extremely reluctant to undergo further examinations. Presently, we’re treating limb bone hyperplasia, so asking them to do chest imaging exams may not find agreement.”

Out of trust for Li Jingsheng, Zhong Hu decided to request a chest X-ray for the patient.

Though some patients are difficult to convince.

Ordering tests unrelated directly to their complaints often leads to criticism.

“I’ll return to the outpatient clinic then. If any abnormalities show up in the test results, I’ll come back after work to assist with the consultation.”

Li Jingsheng quickly left.

By around four in the afternoon, Zhong Hu called.

“Xiaoli, our nurse just convinced the patient to take the most economical X-ray chest film, revealing patchy shadows in the lower right lung.”

Zhong Hu said excitedly.

“This diagnosis has achieved a major breakthrough. However, I still don’t quite believe it’s cancer. I suspect it might be a rare lung bone joint disease.”

Zhong Hu usually wears a stern face amongst doctors and is even bold enough to clash with Professor Wu.

Unexpectedly, he is as meek as a cat before patients.

It took them until four in the afternoon, simply to conduct ideological work so the patient agrees to the X-ray.

And it’s only a chest X-ray.

It’s cheap but yields very limited results.

What you pay determines what you get.

X-ray chest films have limitations.

For this patient, it could have been done all at once with a chest CT.

“I still firmly believe the patient’s illness is cancer. Lung cancer plus bone cancer.”

Li Jingsheng is very resolute.

The Bone Touching Skill has always been very precise, especially as his skills have improved now, it’s even more so.

The bone sensation he detected was like dead wood, indicating a 99% possibility of cancer.

Lung bone joint disease is a paraneoplastic syndrome.

It is caused by tumor tissues secreting biologically active proteins or peptide hormones, leading to local or systemic nonspecific clinical manifestations.

The most common symptom of lung bone joint disease is periosteal proliferation, resulting in the formation of new bone.

But this disease most commonly occurs at the distal long bones.

And it often results in clubbing fingers and hypertrophic osteoarthropathy.

The patient’s joint swelling is clearly due to enlargement, not hypertrophy.

This is one of the questions.

Zhong Hu is so certain the patient has lung bone joint disease because the patient has a long-term smoking history.

Generally speaking, this disease has a certain correlation with smoking history.

But no research institution, doctor, or team has dared to say this disease is linked to smoking.

“Director Zhong, why don’t you further conduct a chest CT for the patient?”

Li Jingsheng asked.

Actions speak louder than words.

Talking a hundred times, a thousand times is not as substantial as obtaining a chest CT film.

“Alas, I’d like to get a straight answer, but the patient and family refuse, so I’m helpless!”

Zhong Hu was rather helpless.

…

Six consecutive days have passed, Li Jingsheng continued his daily work, remaining extremely busy.

Ultimately, that patient with abnormal limb elongation did not agree to undergo further examinations.

Facing such patients, medical staff also felt quite helpless.

Doctors and nurses, each with a heart of a Bodhisattva, but when patients don’t cooperate, there’s nothing anyone can do.

Zhong Hu treated the patient according to pulmonary osteoarthropathy.

Mainly focused on anti-infection treatments.

Seeing that it had been treated for nearly a week, but the patient’s condition did not significantly improve.

The family questioned the hospital’s diagnosis and treatment level and forcibly discharged the patient.

This situation happens often in hospitals, known as auto-discharge.

Patients don’t follow the normal procedure and leave the hospital without the doctor’s or nurse’s permission, this is called auto-discharge.

Some patients auto-discharge because they owe the hospital treatment fees, can’t pay, or are unwilling to pay, so they choose to auto-discharge.

At noon, Li Jingsheng went to the orthopedic office to help his future wife with difficult cases, as usual.

The second group she was in had poor performance, and if he didn’t help, they might really be canceled, and Ou Qinglan might have to go to another group.

He loves her, so naturally, he wants to respect her choice.

Since she wants to stay in the second group, then so be it.

Li Jingsheng was helping her diagnose and analyze a bone injury case when a doctor under Director Zhong Hu hurriedly ran into the office.

“Dr. Li, Dr. Li, that patient is back again, Director Zhong is asking you to come to the office immediately.”

“Which patient?”

The statement was vague.

Li Jingsheng felt a bit puzzled.

“The patient with limb bone hyperplasia who auto-discharged this morning!”

“Oh, it’s him, even if he’s back, it’s still the same result.”

Li Jingsheng didn’t really have a good solution for this case either.

Lung cancer, with bone metastasis, to be frank, it’s just a matter of time.

If nothing unexpected happens, the patient probably doesn’t have long before reaching the end of his life.

Li Jingsheng went to Director Zhong Hu’s office.

In the small office, there were three people present.

The patient with limb bone hyperplasia, his wife, and son.

The patient’s wife already had red eyes from crying.

The son should be about thirty years old, similar in age to Li Jingsheng.

When the old man was admitted to the hospital, Li Jingsheng didn’t see the patient’s son. Only the patient’s wife was by the bedside.

Young couples, old companions.

Sometimes, being kind to your partner is quite necessary.

When either spouse falls ill and is sent to the hospital for emergency treatment, the person with the authority to sign and make decisions is often the spouse.

Siblings, in general, are not considered primary relatives.

They do not have the authority to make decisions.

Unless the patient has no spouse, or the primary relatives are absent, only in such circumstances do siblings have the authority to sign and decide.

If, usually, one is not good to their wife, resorting to beatings and scolding frequently.

Or if the wife is not good to the husband, showing various dislikes, and being unsupportive, when one truly falls ill needing money for life-saving, the other has the complete authority to choose to give up treatment.

Then it really might lead to death.

“Dr. Li is here!”

Upon seeing Li Jingsheng enter the office, Zhong Hu quickly stood up to greet and reminded the patient and family.

“Dr. Li, I really regret not listening to you and Director Zhong. This morning, my husband went to Qiaobang Hospital for a checkup, had a chest CT scan, and they said it might be a malignant tumor.”

The woman spoke of this matter with deep regret.

In her view, it was her reluctance to spend those few hundred bucks for a chest CT for her husband that led to the delay in the illness.

The patient was also feeling very down.

Generally, when diagnosed with such malignant diseases, the patient themselves is often not informed.

They clearly didn’t hide it from the patient.

This is their family’s matter, so naturally, Li Jingsheng wouldn’t interfere.

“What are your thoughts now?”

Li Jingsheng asked the family.

“We definitely want to treat my father! Director Zhong told us that my dad’s condition was already detected by you seven days ago. But medicine requires evidence, and since we didn’t agree to do the chest CT, a definitive diagnosis was not possible.”

The patient’s son looked at Li Jingsheng with a somewhat complex expression.

He might be slightly older than Li Jingsheng, yet Li Jingsheng is already an expert in the medical field.

This made him quite admiring and very envious.

“Director Zhong, how do you suggest handling this case?”

Li Jingsheng shifted his gaze to Zhong Hu.

He felt it was not appropriate to make decisions on his own, and it was better to let Zhong Hu handle it.

“I respect the wishes of the family and patient. The family wants to hear your opinion, so you go ahead!”

Zhong Hu gave the right to speak back to Li Jingsheng.

“Since you trust me, I’ll go ahead and say it! As for Uncle’s illness, it was found quite late, and multiple metastases might have occurred. With the current medical level, treatment might only extend life by one or two months. Moreover, in the later stages, many complications will occur, and the patient will be particularly in pain. Additionally, after chemotherapy and radiation therapy, the patient might find it difficult to even get out of bed and would need constant care. Moreover, the treatment costs could be as high as hundreds of thousands. Such a large sum is a huge amount for many families. If you choose conservative treatment, our hospital will try to alleviate the patient’s pain and improve the patient’s quality of life as much as possible. The cost will also be relatively low, depending on your choice.”