Chapter 9 - Pancreatitis, the Non-Compliant Patient

Chapter 9: Pancreatitis, the Non-Compliant PatientAt that moment, Zhang Yuan found himself in a state of astonishment. Lin Feng’s medical consultation displayed a level of expertise far exceeding that of a novice. He appeared more like an experienced “seasoned professional.”

His choice of diagnostic tests was focused, and he exhibited unwavering confidence in identifying the underlying cause. Reflecting on his years of experience in the emergency department, Zhang Yuan could only aspire to reach the level Lin Feng demonstrated. Based on the symptoms and clinical findings, he had also considered pancreatitis as a potential diagnosis.

“Is this your first medical consultation?”

“Wow, is there truly such an extraordinary prodigy in this field?” Zhang Yuan marveled within himself.

“Doctor…”

At that moment, the young man glanced at the stack of diagnostic orders, hesitating. As a patient, especially one with limited financial means, he dreaded undergoing various tests. Each test would incur several hundred dollars in expenses. Sᴇaʀᴄh thᴇ N0vᴇlFirᴇ.ɴet website on Gøøglᴇ to access chapters of nøvels early and in the highest quality.

“Doctor, it’s probably just gastritis. I had the same symptoms two weeks ago, and I was treated here with two bags of IV fluids, which helped.”

The patient wished to avoid the financial burden.

Lin Feng shook his head and said, “I’ve reviewed your medical history, and I know you received treatment here for acute gastroenteritis before. However, I believe this time it’s not gastroenteritis but pancreatitis.”

“Please take a deep breath.”

“Inhale, cough, ah, ah.”

The overweight young man grimaced in intense pain, clutching his stomach.

“You see, this is also one of the signs of pancreatitis… I just listened to your heartbeat, and it was shallow and rapid. Many of the symptoms suggest it might be pancreatitis.”

However, the obese young man remained unconvinced. He was incredibly stubborn.

“No, it must be gastroenteritis. Just give me an IV drip.”

“Doctor, please help us save some money.”

Desperately, the overweight young man offered a cigarette and pleaded, “Doctor, could you save us some money?”

At that moment, Lin Feng felt a throbbing headache.

“Doctor, we’re struggling financially.”

“Doctor, could you prescribe more affordable medications?”

“Doctor, help us save some money.”

Many doctors often disliked such comments, as they felt their professional ethics were being questioned (even though, regrettably, some doctors do exhibit poor ethics).

Suppressing his frustration, Lin Feng advised, “If cost-effective options are available, I will certainly assist you. However, in my professional opinion, I strongly recommend undergoing the recommended tests for your condition.”

He patiently explained to the obese young man “pancreatitis” and its potential dangers.

The chubby young man persisted, pleading, “The tests take too long. Can we start with the IV infusion first?”

Lin Feng: “…………”

Ultimately, the patient stubbornly clung to his stance with a determined expression. Lin Feng spoke firmly, “Either you comply with the recommended tests or seek another doctor!”

Lin Feng refused to compromise on his diagnostic principles. He would never haphazardly prescribe treatment plans. If anything were to go wrong later, who would be held responsible?

“Next!”

The corners of the obese young man’s mouth twitched, but eventually, he took the diagnostic orders and proceeded with the tests.

An hour later, the obese young man returned with the test results. The amylase levels were five times higher than the normal range. The lipase levels were four times higher. The CT scan revealed clear indications of pancreatic leakage. Considering all these findings and his vast experience, Lin Feng made a definitive diagnosis.

“Doctor, how is it? Is it gastroenteritis?”

“It’s pancreatitis… You need to prepare for admission.”

Lin Feng understood that pancreatitis was not a minor illness. Failing to diagnose and treat it promptly could have severe consequences, even leading to death.

“What? Admission?”

The obese young man was utterly shocked. He abruptly stood up, staring at Lin Feng in disbelief.

“It’s just a minor case of pancreatitis. Why should I be admitted?”

Admission meant significant expenses.

Lin Feng had to reiterate the seriousness of pancreatitis and the importance of receiving proper medical care.

“……”

After persistent persuasion from Lin Feng, the obese young man reluctantly agreed to be admitted. Lin Feng contacted the inpatient department, arranged a bed, and completed the necessary admission paperwork.

At that moment, the obese young man mentioned, “I need to use the restroom.”

Lin Feng responded, “Take a left when you leave.”

Five minutes passed…

Ten minutes passed.

Fifteen minutes passed.

The obese young man had not returned.

“What? Did he escape?”

At that moment, it dawned on Lin Feng that the young man had avoided admission!

Countless expletives filled Lin Feng’s thoughts.

“Well, it’s not my life.”

For the first time, Lin Feng realized that no matter how skilled he was as a doctor, he couldn’t guarantee every patient’s recovery. He continued attending to other patients, but his mind remained preoccupied with the obese young man. Eventually, unable to bear the thought of the patient’s potential demise, he asked the nurse to try and reach out to him. However, despite numerous attempts, there was no response to the calls.

Lin Feng gave up.

“Some stubborn people are hard to convince.”

Soon, he pushed the patient out of his mind.

However, on the third day, the Intensive Care Unit (ICU) contacted him, informing him that they had admitted a patient with severe acute pancreatitis and that urgent surgery was required.

They requested Lin Feng’s consultation.

Lin Feng was puzzled, “Why do they need me? I’m an emergency physician. Shouldn’t they invite specialists from various departments?”

The ICU nurse explained, “Dr. Lin, the thing is, this patient came to the emergency department two days ago, and you were the one who made the diagnosis. You’re more familiar with his condition and can provide valuable insights…”

Suddenly, he clicked for Lin Feng, “Ah, it’s him. He agreed to admit?”

After ending the call, Lin Feng hurriedly made his way to the ICU. He couldn’t help but feel a sense of speechlessness that the obese patient had allowed his condition to worsen, progressing from acute pancreatitis to severe acute pancreatitis.

Acute pancreatitis, a condition characterized by inflammation of the pancreas, could be managed through medication in most cases. However, surgical intervention was necessary to remove the necrotic tissue in severe acute pancreatitis where there was significant tissue damage. This form of pancreatitis constituted approximately 20-30% of cases and had a considerable in-hospital mortality rate of 15%.

Additionally, the treatment costs associated with this severe condition were exorbitantly high. Considering these factors, the pursuit of such treatment was deemed unworthy.