Sent to the countryside, I turned the health center into a top-tier hospital.

Chen Ping continued, "Besides the fever, are there any other discomforts? Do your joints hurt? Are there any growths on your body?"

The man thought for a moment and said, "My joints don't hurt, but my fingers have been a little numb and not very flexible for the past few days."

Chen Ping didn't reply, but pulled the man's hand over and looked at it.

The skin at the fingertips is darker in color, the nails are slightly more curved than before, and there is a slight clubbing change, which is not very obvious, but can be seen in the morning light.

He then took out a small pen-shaped flashlight from his pocket and had the man pull back his eyelids to shine the light on his eyes. There was a tiny bleeding point under his right eye, like a needle prick.

He picked up the temperature record sheet on the bedside table again and glanced at it a few times. Then he stood up, walked to the window, and rearranged the stack of test reports in chronological order.

From complete blood counts to inflammatory markers, from blood culture results to CT imaging reports, I flipped through page after page.

The young doctor stood beside him watching him flip through the reports, his expression a mix of curiosity and anticipation, but he kept his lips pursed and remained silent.

Chen Ping paused when he turned to the second page, then flipped back to compare the blood culture results from the day of admission and the third day of admission. Both cultures showed "no bacterial growth" and no fungi.

However, he noticed a detail: in the notes section of the blood culture report, there was a line of small print: "Antibiotics were used before the specimen was collected."

He pulled out the form and placed it aside, then continued flipping through the pages.

The CT report included an abdominal CT scan that indicated "the liver and spleen are of normal size and shape, with no obvious abnormal density shadows." However, the description at the bottom of the scan stated, "A small lymph node shadow, about 0.8 cm in size, is visible in the splenic hilum region. Follow-up is recommended."

He took out the report and placed it aside. Instead of rushing to a conclusion, he went to the bedside, put on his stethoscope, and bent down to listen to the patient's heart and lungs.

The heartbeat is regular, but a very faint systolic murmur can be heard in the mitral valve auscultation area.

It wasn't typical, but you could hear it in the quiet ward; it sounded like the faint, intermittent sound of wind blowing through a narrow crack.

Chen Ping straightened up, took off his stethoscope, and then pulled the patient's wrist to take his pulse.

The pulse is floating, rapid, and strong, but there is a slight hesitancy in the heart pulse area, as if something is blocking the blood flow channel. Although it is not completely blocked, it makes the pulse flow less smooth.

At that moment, his mind automatically conjured up a diagram of the patient's anatomy, while his heart beat steadily in his chest.

A tiny growth, like a grain of rice stuck to damp paper, was attached to the posterior leaflet of the mitral valve. Its edges were blurred and its texture was loose.

He released his grip, looked at the young doctor by the bedside, then glanced at Dean Liu, and said, "The patient doesn't have a common infection; it's infective endocarditis."

"The blood culture was negative because antibiotics had already been used in the community before admission. The timing of the sample collection was incorrect, so nothing could be cultured."

"The lesion is on the posterior leaflet of the mitral valve. It is very small, so it cannot be seen by a regular transthoracic echocardiogram. However, this vegetation keeps shedding tiny bacterial plugs, which travel through the bloodstream to various organs throughout the body, causing recurrent fever."

"The patient's retinal hemorrhages and clubbing of the fingers are both peripheral manifestations of long-term microembolism."

Dean Liu took a step forward, a hint of surprise in his eyes. "Are you sure?"

Chen Ping pointed to the abdominal CT report on the bedside table, "The small lymph node shadow of 0.8 cm in the splenic hilum is a reactive hyperplasia after splenic microembolism, which was mistaken for a normal lymph node and did not attract attention."

"If this continues, the growths will continue to detach, and the next step will be a cerebral embolism."

Chen Ping was very confident because the diagram of human anatomy that formed in his mind was clearer than any instrument could see.

The young doctor stood to the side, initially keeping his lips pursed and silent, but later slightly opened his mouth.

"I just performed two transthoracic echocardiograms on him last month, and both were normal," the young doctor said.

Chen Ping glanced at him and said in a flat tone, "Transthoracic ultrasound is sensitive to large valvular vegetations, but it cannot detect these early small lesions through the transthoracic probe."

"I recommend getting a transesophageal echocardiogram. The resolution is much higher, and you can see things very clearly."

The young doctor was silent for a few seconds, then nodded, turned around, and went out to make the arrangements.

Dean Liu stood by the bedside, his face full of puzzlement, and said, "You can feel something on the heart valves just by taking my pulse?"

Chen Ping shook his head. "I can't see the valves when I take the pulse, but I can feel an unusual sluggishness in the pulse, like a stone suddenly appearing in a river, and the water flow starts to slow down."

"The pulse won't tell you the specific morphology of the lesion, but it can tell you that you're going in the wrong direction. Once you've found the right direction, the rest is just a matter of what tests to use to verify it."

"Okay, then we'll wait for the test results." Dean Liu nodded.

The young doctor returned quickly, and an esophageal echocardiogram was scheduled for 10:30 a.m. that day.

Chen Ping sat on a bench outside the ward, waiting for the results.

Dean Liu didn't leave either. He stood at the end of the corridor, whispering something to a few doctors, occasionally glancing back at the direction of the examination room.

The young doctor ran around busily, signing test forms, coordinating with the ultrasound department, and never putting down the medical record folder.

At 10:40, the lights in the examination room went out and the door was pushed open from the inside.

The ultrasound doctor came out with a printed report in his hand.

He handed the report to Dean Liu and said calmly, "A vegetation measuring approximately 0.5 x 0.4 cm is visible on the posterior leaflet of the mitral valve. It is attached to the edge of the leaflet, has considerable mobility, and exhibits heterogeneous echogenicity, consistent with the ultrasound findings of infective endocarditis."

Dean Liu took the report and looked at it for a long time without speaking immediately.

The young doctor stood to the side, his gaze also fixed on the report, his lips pursed, the pen in his hand never being put down.

He turned to look at Chen Ping, his eyes no longer showing the aloofness and resentment he had when they first met that morning. Instead, they held admiration and a sense of complete acceptance.

Dean Liu folded the report and put it in his pocket. He walked up to Chen Ping, stopped, and shook his hand. "Dr. Chen," he said, "your diagnosis saved that patient's life. If we had delayed it for another week, the growth would have broken off and entered a blood vessel in his brain. I don't even want to think about the consequences."

Chen Ping smiled and said, "The patient is lucky. The problem was discovered relatively early. With the use of sensitive antibiotics and surgery to clean the valve, the prognosis should be good."

Dean Liu released his grip, his gaze lingering on Chen Ping's face for a couple of seconds before he said in a very serious tone, "Dr. Chen, why don't you stay in the provincial capital for a few more days? You don't need to see patients; just help us examine those patients with unexplained illnesses."

"Your compensation will be based on the standards of our institute's top experts. Accommodation will be provided in a guesthouse, and all meals and lodging will be included. All you need to do is come and take a look around every day."