American Medicine: I survived the death knell thanks to the devil.

Bone tuberculosis?

This term was extremely unfamiliar to the elite doctors from Manhattan present.

It's not that they're stupid.

They just haven't seen it before.

Even the smallest probability, when multiplied by 1.4 billion, becomes a significant amount.

How much does it cost to register at an outpatient clinic in China?

After deducting medical insurance, it costs a few yuan. A specialist appointment is more expensive, costing tens of yuan.

After medical insurance coverage, the portion of the medical insurance payment that ordinary people have to pay out of pocket is something they can afford if they grit their teeth.

Therefore, all kinds of patients can be found in orthopedic clinics in China, including those who have fallen from construction sites and those who have traveled eight hours by bus from the countryside, carrying their X-rays from the county hospital.

Seeing 60 or 70 patients a day is the norm; all sorts of strange illnesses are piled up in front of you.

The more you see, the more you will recognize.

In the United States, however, someone without commercial insurance who wants to see an orthopedic doctor must first make an appointment with a general practitioner.

General practitioners have a two- to three-week waiting list.

After seeing the general practitioner, the general practitioner will write a referral letter to the orthopedics department, and then you will be scheduled for another two to four weeks.

Two months passed before I finally sat down in front of the orthopedic specialist.

But this only exists in theory; in reality, the waiting time is uncertain.

Just like boarding a plane, the rich can use the first-class lane.

For them, seeing a doctor might be much faster, but for the poor...

You asked what to do while waiting?

Just take painkillers and bear it. Other things may be expensive in the US, but a big bottle of painkillers isn't that expensive, and they often have big sales.

When the painkillers stop working...

How about considering a reinforcing agent?

If an intermediary insurance company refuses to authorize a certain inspection, you must call to appeal.

The appeal process takes seven to ten business days. If the appeal is rejected, you can appeal again.

Many people give up after the second round, not because they're cured, but because they can't afford to keep going.

So how many patients do orthopedic surgeons in the United States see in a day?

Fifteen to twenty.

Some private clinics see eight to ten patients a day, with each patient having half an hour, and there are also administrative documents to process in between.

They value satisfaction and benefits more than the efficiency of medical care.

Over the course of a year, an American orthopedic surgeon sees about one-fifth the number of cases that his Chinese counterparts do.

Rare diseases are truly rare here.

It's not that the disease doesn't exist, it's that the patients simply can't get to them.

By the time they arrive, more than six months have often passed, and all the necessary delays have been made.

During his time at a top-tier hospital in China in his previous life, Lynn saw more than thirty cases of bone tuberculosis.

I've seen all sorts of subtypes, including those of the spine, pelvis, and limbs.

One year, we even admitted a case of multifocal bone tuberculosis complicated with tuberculous meningitis. The entire hospital held a joint consultation, and the patient was eventually saved.

Those experiences, nurtured by blood and sweat, are etched into his mind.

……

"Nonsense!"

Prescott was the first to react; he felt as if his carefully constructed stage had been utterly destroyed by a mere resident doctor.

"Bone tuberculosis? Do you think this is a slum in the Third World? The patient's white blood cell count isn't significantly elevated at all!"

"Tuberculosis is a specific infection, so white blood cell counts wouldn't normally rise significantly. You've already interpreted the abnormalities in erythrocyte sedimentation rate and C-reactive protein as tumor absorption fever."

Lynn wouldn't budge an inch. "If you follow the protocol for disappearing bone disease or bone tumors today, you'll have to cut open that cold abscess for an open biopsy."

"The tuberculosis bacteria can spread rapidly throughout the body via a ruptured blood vessel. She won't die from the bleeding; she'll die from acute miliary tuberculosis or tuberculous meningitis!"

"That's enough!"

Professor Sterling, who was sitting in the head seat, slammed his hand on the table.

The academic giant from Yale University looked displeased.

His proudest student, the student he had just praised as "sharp," was now being humiliated by a lowly Asian resident.

"Young man, medicine is a rigorous science, not a talk show for you to impress the crowd."

Professor Sterling stared at Lynn.

"You think you can overturn the gold standard of pathology with a few unsubstantiated slum stories? Is this how the residency training system at Metropolitan Hospital teaches you to question your superiors?"

Garrett immediately stood up.

"Dr. Lin, your current behavior has seriously violated the hospital's hierarchical management regulations."

"I suggest you leave this meeting room immediately and carefully consider your future at this hospital. Your annual evaluation report is still in our hands."

A blatant application of pressure from the academic system.

If you can't solve the problem, solve the person who raised it.

As long as Lynn is kicked out and the case is made into a case of disappearing bone disease, the paper will still be published.

Even if the patient eventually dies from a "rare complication," it will only be a regret on the road of medical exploration.

Julian sat in the corner, looking at the group of sanctimonious faces.

He suddenly felt incredibly nauseous.

This is the upper-class medical circle that he was taught from a young age to join.

To please their mentors and to get published in top journals, they can ignore a girl's night sweats and weight loss, forcibly piecing together false positive data to create the shape they want.

In their eyes, human life is just an N value in a thesis.

"Bang!"

Julian abruptly pushed back his chair and stood up.

"He didn't try to gain attention."

Julian's voice echoed in the conference room.

"Lynn is right. You don't care what illness the girl has; you only care whether that illness is worthy of Professor Sterling's academic standing!"

The entire audience erupted in uproar.

Garrett stared at him in disbelief. "Julian, are you crazy?"

Prescott was so angry he laughed.

"Dr. Julian, have you forgotten why you were 'rotated' back to the ER? Do you think the Cabot family will clean up your mess by spouting nonsense in this room?"

"Do you think the Cabot family would bother with something as trivial as a stranger arguing with Professor Sterling?"

Julian clenched his fists, his knuckles turning slightly white.

Just as he was about to speak, the heavy walnut wood door of the conference room was pushed open again.

"Whether the Cabot family cares or not, I don't know."

A deep, hoarse, and oppressive voice came from outside the door.

The orthopedic luminary of Metropolitan Hospital, Old Hudson, walked in slowly and deliberately, leaning on his cane.

He was holding several freshly printed lab reports in his hand.

The old man's gaze swept over Prescott's pale face, over Sterling's stiff expression, and finally landed on Garrett.

"But the Cabot family doesn't care, and I happen to have some free time."

Old Hudson slammed the lab report on the long table with a "thud".

"Ten minutes ago, I personally sent someone to the laboratory to perform acid-fast staining on the patient's joint aspiration fluid."

Old Hudson, leaning on his cane, sounded like an old lion surveying its territory, his voice so loud it made the glass of the conference room tremble slightly.

"Acid-fast bacilli positive. Bone tuberculosis diagnosed."

He stared at Prescott, his eyes filled with disappointment and disgust.

"Pack your things and get out of my department. I don't need butchers who kill for the sake of publishing papers."