Evolution 2030: Studying Medicine Won't Save Americans

Chapter 16 Suprametrial Artery Syndrome

Omar hadn't actually walked up to Chen Yisen yet; he was still not far from the doorway.

The two people closest to him were the medical director who was the first to go up and inquire about the situation, and Natalia, who had just walked over.

So to outsiders who didn't know the situation, it looked like Omar knelt down before them the moment they met.

"ha?"

The on-site supervisor was so startled that he jumped to the side.

He is a white man.

Black family members kneel before white doctors.

If someone were to film this scene and add some random captions, then all the hard work of the past ten years or so would have been for nothing.

Natalia, being a white woman, wasn't as sensitive, but she was still a little hesitant to get any closer.

The scene was very embarrassing.

Just then, the woman Omar brought with her let out a painful groan.

Everyone realized that the most important thing now was to determine the diagnosis.

"What's the patient's name? Did they suddenly experience abdominal pain?"

Natalia put on her mask, directed several nurses to get the equipment, and asked Omar a question.

"Stacey Jaberley, she's had a stomachache for a few days..." The latter wiped the sweat from his forehead, "I happened to hear there was a community health event here today, so I brought her over to get checked out."

Chen Yisen also arrived at this moment and noticed that this Stacey should be of West Asian or North African descent. Her light brown face was covered with sweat due to pain, and her facial features were almost distorted together.

"Have you been to the hospital in the past few days? Have you taken any medication?"

As soon as Natalia finished speaking, Stacy's body convulsed violently.

Then.

"vomit--"

A small amount of solid-liquid mixture was expelled.

Almost all of it was undigested food.

"Let's move him to the temporary observation area at the back first; it's not going to work here." The on-site supervisor directed several medical students to carry the person, and then gestured for Zuma and another nurse to follow. "You two go and draw blood and collect urine samples from the patient, and then do a routine check-up in the car."

The temporary observation area was where Chen Yisen was taken to rest when he first arrived in the morning.

It's like a hospital ward where you can't stay for long.

"I took the medicine a few days ago, but... it didn't work." Stacy had regained some of her speech and answered Natalia's question with difficulty.

The latter quickly waved his hand at her: "The patient should try not to say too much, let the family answer."

Then he looked at Omar: "What medicine did you take? Did you go to the clinic?"

But no answer was received.

Chen Yisen certainly knew why the other party was hesitant.

Those underground clinics that can operate stably all have some gang connections.

Someone like Omar, who can even pull off a robbery so skillfully, is definitely not someone you should mess with.

So Chen Yisen immediately interrupted Natalia, who was about to continue asking questions: "Don't worry, we won't care what kind of clinic you went to, or where the medicine came from... but this information is very important for determining Natalia's condition."

After a brief hesitation, Omar pulled two medicine boxes from his pocket: "I don't know, but these are the two types."

"Sconizuron and norfloxacin," Chen Yisen glanced at it and judged, "probably thought it was a bacterial enteric infection."

This treatment approach is similar to that of township health centers in the 1990s.

For any abdominal pain, first relieve the spasms, then reduce the inflammation; this method is usually correct.

He even suspected that the doctor at the illegal clinic was a quack.

But since it hasn't worked after several days, we can preliminarily rule out this as the cause.

As they spoke, the group packed up their equipment and equipment and headed to the temporary observation area.

On the way, Chen Yisen asked Omar, "Didn't I tell you last night that you could go to the clinic?"

Omar glanced at Joey out of the corner of his eye, still shaken, and only dared to raise his voice slightly after making sure the latter wasn't following him: "After I got back last night, Stacey said she wasn't feeling so bad, but after lunch just now, it suddenly got worse again..."

About ten minutes later, Zuma hurried back from outside.

After hesitating for a moment at the door, I handed the blood test report to Natalia.

The latter glanced at Chen Yisen, seemingly displeased that Chen had suddenly interrupted his conversation with Omar.

However, this shouldn't delay the treatment process.

He glanced at the report and made a gesture to Zuma, who quickly ran out again.

Chen Yisen could understand that it meant the latter should prepare a urine pregnancy test.

趁着这段功夫，娜塔莉亚念出报告单上的内容：「血红蛋白73g/L、白细胞11.3*10^9/L、中性粒细胞76%、淋巴细胞20%、血压97/65mmHg……」

Then, his gaze swept over the group of medical students around him.

Clearly, Chen Yisen isn't the only one who likes to ask questions to young people.

"Could it be internal bleeding caused by gastroenteritis?" one of the bolder individuals offered.

Judging from the test report alone, this is the least likely result to be correct.

But this does not reflect Stacey's actual situation.

"But there was no blood in the vomit just now," said the only female student among the medical students.

At this moment, Zuma reappeared from the doorway, but empty-handed: "The reagents are all used up. The car I went to get from the hospital is still on its way and won't be back for at least half an hour."

Natalia patted her pockets and looked around at the people around her: "A pregnancy test will do, but a medical one would be best."

No one answered.

"I have some." A charming female voice with a slight French accent came from out of everyone's sight.

It's that reporter who interviewed Natalia this morning; he's still here, and I don't know when he started lying in wait.

"What are you doing..." Natalia tried to shoo her away.

But a small, shrink-wrapped cardboard box was already shoved into her hand: "Do you need this?"

Natalia quickly opened the package, and without even instructing the nurses, she personally performed the urine test.

While waiting for the results, Chen Yisen glanced at the reporter with some curiosity.

He never expected that someone would actually carry such a thing with them.

The other person's eyes were fixed on the pregnancy test on the table, but they still sensed that someone was watching them and knew exactly why.

"I sometimes interview... well... marginalized women, so carrying some women's products with me makes it easier to connect with them."

Chen Yisen was taken aback for a moment before realizing that this was an answer to a question he hadn't actually asked.

The reporter then turned around and asked, "So, what illness do you speculate Ms. Jaberie suffers from?"

Perhaps sensing some kind of conflict between the two attending physicians present, she faced the camera at a very subtle angle, making it difficult to determine who she was actually asking the question to.

Chen Yisen wasn't going to take the bait; he just glanced at the employee badge hanging around the reporter's neck.

ProPublica, the group for racial and economic justice.

Reporter: Erin Ginesta.

But Natalia singled him out: "Dr. Chen, a young woman presents with acute abdomen, low blood pressure, and anemia all at once. According to the guidelines, what should be considered first?"

???

Not only Chen Yisen, but everyone except Eileen was stunned after hearing this.

Asking this kind of question to a medical student is fine, but even asking a senior resident would be considered an insult.

It's almost equivalent to publicly questioning someone's competence.

Not to mention that Chen Yisen is already the attending physician.

She's on the same level as you, Natalia.

But now there's an uninformed reporter watching nearby, so it's difficult to refuse to answer or cause a scene.

"An ectopic pregnancy should be considered first," Chen Yisen replied calmly, just as he had when he was a resident physician under the other party.

But she then added, "However, that's textbook stuff. In reality, Stacey's symptoms had been present for several days and were intermittent, so it's almost impossible... The pain of an ectopic pregnancy should be tearing and continuous."

This was purely taking advantage of Natalia's lack of knowledge about the full situation, since Omar had spoken to her alone earlier.

Furthermore, Chen Yisen's logic is not difficult for laymen to accept, which makes Natalia seem like a clown who only knows how to recite from a script.

In fact, if a woman of childbearing age experiences acute abdominal pain and hemodynamic instability, an ectopic pregnancy should definitely be investigated first.

Natalia's actions were fine.

However, since she was determined to cause trouble for Chen Yisen, the latter was not someone to be trifled with.

Just then, the pregnancy test on the table came back positive.

"Negative." Frank, who had been following Chen Yisen that morning, promptly added insult to injury.

Natalia's face stiffened.

A negative pregnancy test doesn't completely rule out pregnancy, but considering what Chen Yisen just said, the possibility is very low.

"Mr. Campos, I need to touch and press on the patient's upper abdomen to give a more detailed diagnosis." Chen Yisen decided to step in and end this farce.

Omar was extremely anxious, but he couldn't understand a word the doctors were saying.

Now that someone was finally willing to talk to him, he naturally nodded quickly.

Chen Yisen's palm emitted an extremely weak electric current once again, which instantly seeped into his abdominal wall.

This was the first time he had used this ability to explore the human abdominal cavity.

We need to work hard to match the perceived scenes with the human body models in the textbooks.

In his past life, Chen Yisen had seen many abdominal cavities, but few were intact.

The abdominal aorta was the first to "light up".

A thick, tubular structure with impedance that changes periodically with pulsation runs close to the front of the spine, like an underground river.

Another vessel branching off from the anterior wall of the aorta at an acute angle is the superior mesenteric artery (SMA).

Between the two "scissors" formed by the two, the duodenum, which should be three fingers wide, is like a soft tube being flattened by giant vascular clamps.

However, the proximal gastric antrum and duodenal bulb dilate into a low-resistance fluid sac, where the accumulated chyme and bile cast a heavy shadow, making it difficult to "see" the condition of the lumen.

By searching through his own internal medicine knowledge, Chen Yisen learned that this condition should be called suprametrial artery syndrome.

This cheat code is really useful.

But it's the same problem I encountered this morning.

Doctors are not omniscient; a diagnosis requires evidence.

I had no choice but to continue searching for the typical features of superior mesenteric artery syndrome.

Even Chen Yisen himself was starting to lose his composure—

The phrase my teachers used to say most often when I was in school was, "Patients won't get sick according to the points I draw for you."

Who would have thought that he would actually be treating patients based on their specific needs?

"Have the patient lie on their side," Chen Yisen instructed naturally, stepping past Natalia.

Omar and a nurse stepped forward and somewhat clumsily turned Stacey's body 90 degrees to a side-lying position.

As the posture changed, a slight gap appeared between the two blood vessels in the image formed by electrical impedance tomography.

Stacy's complexion was much better than before.

Chen Yisen finally confirmed the diagnosis: duodenal stasis and suprametrial artery syndrome.