51 The Pressure Of Silence (2/2)
Hu Yín Tao: ”Erm I, Erm”
Li Xiuying: ”Go and see Mr. Mao Ting bed 10. Take a history and do an examination. Then come back and present. You have 15 minutes.”
Hu Yín Tao walked dejectedly to the patient.
I made myself look so stupid! Dr. Li must think I'm and absolute idiot now.
When the patient was within Hu Yín Tao sights, she composed herself.
Hu Yín Tao: ”Hello Mr. Mao Ting. I'm Dr. Hu.”
Mao Ting was sitting on the edge of the bed: ”Hello Dr. Hu.”
Hu Yín Tao: ”I'll be asking you a few questions and then do an examination. I'll then go and report to my senior and she'll come to review you.”
Mao ting: ”Sure.”
Hu Yín Tao: ”Tell me what's happened to bring you in today.”
.....
Li Xiuying was sitting at the desk waiting for Hu Yín Tao to return. It had been 17 minutes since Hu Yín Tao had gone to assess the patient.
Li Xiuying leaned on the desk and put her head in her hand. She strummed the fingers of her other hand on the desk. Li Xiuying took her phone out of her pocket and sent a message to Ren Daiyu and Xǔ Junjie: 'I finish work at 2:30.' She returned her phone to her pocket.
Hu Yín Tao appeared after 25 minutes.
Li Xiuying: ”25 minutes. Present.”
Hu Yín Tao forced herself to sound confident: ”I'll be quicker next time. I saw Mr. Mao Ting a 35 year old male who has presented with loin to grain pain. The pain started 2 weeks ago. It feels sharp, and doesn't radiate anywhere else. He doesn't have any urinary or bowel symptoms. It's a constant pain. It's worse on movement, and he scaled it at 8/10.
He has no other medical conditions. No surgical history. He is not taking any medication and is allergic to penicillin. He does not have a family history of any diseases. He works as a taxi driver, smokes cigarettes 20 a day and is a social drinker.
On examination: He did not have any peripheral signs of any disease. His abdomen was soft and non-tender. No signs of organomegaly. His inguinal lymph nodes were not enlarged.”
Li Xiuying: ”Management?”
Hu Yín Tao: ”I would like to get a set of obs, urine dipstick and a set of bloods. I think the patient may need a CT KUB.”
Li Xiuying: ”Differentials?”
Hu Yín Tao: ”UTI, Kidney stones, kidney cancer; transitional being the most common or squamous cell carcinoma, bladder cancer.”
Li Xiuying: ”Aorta?”
Hu Yín Tao confusedly asked: ”Aorta?”
Li Xiuying: ”Important differential to exclude for loin to groin pain is aortic dissection.”
Li Xiuying: ”Check his aorta and then order all the investigations you listed. Pain relief?”
Hu Yín Tao nodded: ”I'll prescribe PRN paracetamol.”
Li Xiuying looked at the computer screen and clicked on a name: ”Your next patient is a 85 year old female patient with left lower abdominal pain. Bed 6. I'm going to see the patient in Bed 2. You have 17 minutes.”
Hu Yín Tao: ”Yes.” She quickly walked back towards Mao Ting.
...
Li Xiuying and Hu Yín Tao continued seeing patients non-stop until 2:30.
Hu Yín Tao felt both physically and mentally exhausted; her brain was filled to the brim with new medical knowledge. Hu Yín Tao had never felt so under pressure; Dr. Li was the type of doctor who would wait for you to give an answer no matter how long it would take.
Dr. Li's gaze had made Hu Yín Tao feel like all her inner thoughts were being seen through, analysed and rejected. The more silence there was the more pressure Hu Yín Tao felt, the more nonsense she spouted and the more of an idiot she felt.
Hu Yín Tao counted that Dr. Li had frowned at her a total of 67 times.