medical simulator

Chapter 140 Damn, pretend to be B and run away! (Please subscribe!)
Luo Yun looked at Zhou Cheng, and Zhou Cheng turned to explain to Zhang Zhengquan.

The eyes on Zhang Zhengquan's big black face opened forcefully, revealing an extremely complex look.

Zhou Chengcheng said: "Hysterical pain, in fact, it should be divided into two points. Hysteria is the name of the main disease, and pain is one of the manifestations of hysteria."

"Hysteria can also be called dissociative conversion disorder, which is a mental disorder caused by psychological factors acting on susceptible individuals. It is a mental disease."

"In addition to pain, its manifestations can also include convulsions, cramps, sudden body paralysis, inability to move, or memory loss. It can also be manifested as loud shouting, moodiness, difficulty breathing, blindness, etc..."

"Of course, other manifestations are not reflected in this patient. Let's talk about this patient first—"

"Hysterical pain is generally migratory."

"The pain symptoms of this kind of patients are completely different from the pain caused by organic injuries."

"Her pain is that she feels pain, and she can feel no pain very quickly. This is one of her characteristics."

"One of the easiest ways to diagnose is to guide the patient a little deliberately to see if her pain can suddenly shift."

"It's like just now when Mr. Luo took advantage of his unpreparedness, he suddenly disrupted the patient's train of thought!"

"It made her feel that her painful hand should be on the left side, and she also felt that her painful hand was on the left side, but in fact."

"We have all seen that when the patient first came in, the painful part that the patient told us was actually on the right side..."

Zhou Cheng said so much in order for Zhang Zhengquan to understand.

Zhang Zhengquan has a good relationship with him and has helped a lot, Zhou Cheng has long wanted to take him along.

Luo Yun had already seen through the case just now, and Zhou Cheng had also seen through it, but Zhang Zhengquan didn't understand it at all. Zhou Cheng could only break up the disease and feed it to him, which was reciprocal.

So after continuing to organize the language, he continued:
"If there is metastatic pain, then you should go to the neurology department or psychiatry department for treatment and treatment. Our orthopedics department cannot treat this kind of thing."

"The hysterical pain often occurs after traumatic stress. But that is most of the cases, and the patients and their family members can be sure that the patient has not suffered trauma or surgery."

"However, stress is not directly traumatic."

"In some special cases, there may be situations where there may be violations of our values, and there will be."

"For example, in a traffic accident, as a victim, when you have to pay more money, you pretend to have no symptoms at the beginning, but they really appear after you pretend more times. The patient is really in pain!"

"The other kind is reward addiction! For example, if someone shows pain, it attracts more attention or pampering than usual, which she really wants, and it will also appear."

"So, most of the patients we see are adolescent girls, maybe menopausal women are also more sensitive, and there will be relatively more..."

Zhou Cheng talked eloquently, explaining the profound things in a simple way.

Even Zhang Zhengquan nodded frequently.

From the shock and astonishment at the beginning, it gradually turned into a sudden realization.

Zhou Cheng really explained the disease in detail. Although he didn't summarize it, he explained everything from the pathogenesis of the disease to the reason why it is more common among people. It is not boring. Zhang Zhengquan really understood it.

"There is such a disease, I have never heard of it." Zhang Zhengquan felt very surprised, and bowed slightly.Express my admiration and gratitude to Zhou Cheng.

Luo Yun just smiled and said, "Call the next patient in."

I was also quite helpless in my heart. Although I was surprised by Zhou Cheng's knowledge and knowledge, he didn't say much.

This kind of disease is actually not a disease of joint surgery, but a disease of psychiatry. Luo Yun also encountered it several times in the joint department before he learned about it.This is nothing, in psychiatry, this disease is also a common series.

Zhou Cheng reads a lot, so if he can realize it, it's nothing.

Next time, we must find a very professional disease to have a look.

Zhou Chengzhun was about to step up, Zhang Zhengquan immediately said, "Brother Zhou Cheng, I'll call."

Zhang Zhengquan knew in his heart that the purpose of his coming here today was to earn a living. There were many patients in the outpatient clinic, so he definitely didn't have time to do teaching rounds. Zhou Cheng was willing to say that he could learn something now.

The time of the outpatient clinic is crowded and crowded, and it is not easy to waste a minute.

A second patient came in soon after.

She is an elderly woman with obvious deformity of her right lower limb. She is short, obese, with a very dark complexion and half-white hair that has not been taken care of.

She limped in and was supported by a woman in her 30s, who said, "Mom, walk slowly, and be careful not to trip over your legs."

After entering, Zhou Chengcheng quickly noticed that her right lower limb was obviously turned inward, and her lower limbs were obviously unbalanced.

The left leg is much longer than the right leg. When walking, after the left foot touches the ground, the right side of the body swings.

When her right leg touched the ground, she frowned and gritted her teeth, as if every step she took was in excruciating pain!
"Woman, you sit down first. How many years has your leg been hurting?" Zhang Zhengquan immediately asked the patient to sit down.

The middle-aged woman next to her replied: "My mother has been in pain for more than ten years. It hurts when it rains, and it hurts when I walk, and now it hurts when I sleep. I saw it in the county hospital and took medicine for a while. Now it hurts too much."

"Have you ever taken any pictures in the county hospital?" Zhang Zhengquan asked, looking at the plastic bag twisted in her hand, on which was clearly written C County People's Hospital.

"Yes, but it's been several months. Do you want to see it? Do you want to take a new one?" The woman said while taking a lot of films inside: "When I went to the county hospital before, the doctor It’s useless to say that the previous films are useless.”

"So I took photos every time I rechecked, and I kept a lot of them here."

"The ones from ten years ago to now are still there."

Luo Yun was shocked when he heard the words, and quickly said: "Useful, these films are the most useful!"

Just kidding, these X-rays simply objectively record the progress and history of the patient's condition, how could it be useless?

Neither the patients nor their families can tell the medical history in such a detailed and objective way. This whole set of X-rays can be said to truly record the development and evolution of a disease.

There are a lot of films, and they are arranged neatly. They are all arranged in chronological order. In addition to X-rays, there are also CT and MRI, but both CT and MRI are for the lumbar spine!

It can be seen that either this old woman is a fastidious person, or the middle-aged woman next to her, who is not sure if it is her daughter-in-law or daughter-in-law, is very considerate.

Because there are many films, Zhou Cheng and the others each have a film to watch!

I picked up the most recent film to watch first, and the plain film that was pushed forward a few months may be different from the current illness due to the time gap, but the content in the film is only slightly different.

Zhou Cheng is holding the one from a year ago, while Luo Yun is holding the most recent one.Zhang Zhengquan held the one from nine months ago.

When Zhou Cheng read the films, he found very obvious knee osteoarthritis!

Knee varus deformity.

After Luo Yun flipped through several films one by one, his heart was moved again!
Good guy, this movie is interesting again, so he looked at Zhang Zhengquan and asked, "Zhengquan, did you see something?"

Zhang Zhengquan's face froze immediately when he heard the words, his eyes continued to open a little bit, and after looking more seriously, he turned around and said, "This is knee arthritis!"

Luo Yun rolled his eyes when he heard this.

Ah tui!

What the hell?

Are you ashamed to say such an extremely unprofessional diagnosis of arthritis?

There are many divisions of arthritis, osteoarthritis, septic arthritis, tuberculous arthritis, gouty arthritis...

However, considering that Zhang Zhengquan is not a joint surgeon, Luo Yun will not complain about him.

Before Luo Yun turned his head to look at Zhou Cheng, Zhou Cheng asked the middle-aged woman, "Has your mother had a broken bone before?"

Hearing this, Zhang Zhengquan immediately turned his head to look at Zhou Cheng.

Have a broken bone?
How did you get it?

Brother Zhou Cheng, are you a doctor or a fortune teller?

This is not a good nonsense!
Luo Yun's expression flickered upon hearing this.

In addition to the types of inflammation that can be divided into arthritis, the etiology can also be divided.

This patient indeed had classic osteoarthritis.

The two classic manifestations of osteoarthritis are the narrowing of the joint space and the wear and tear of the articular cartilage. This is written in the definition, and it is also the content that can be read very clearly by reading the film.

but?

The diagnosis of traumatic arthritis is an etiological diagnosis. Generally, this diagnosis can be obtained by asking the medical history to complete the diagnosis.

Because you don’t even ask, how do you know if it’s a trauma?

Traumatic arthritis...

Of course, the traumatic experience of traumatic arthritis will be permanently written on the person's body, and it requires quite advanced film reading skills to be able to see that the patient has fractured or been injured before.

This is a very professional reading skill.

Originally, Luo Yun was going to leave this X-ray to Zhou Cheng and Zhang Zhengquan for a lesson, but he didn't expect that it was just the beginning, and Zhou Cheng would tell the truth again!

Zhang Zhengquan hurriedly asked the middle-aged woman: "Has she ever had a broken bone before?"

"No? My mother-in-law has never been hospitalized or injured?"

The middle-aged woman hesitated for a moment, but she was very sure.

Then he turned his head and asked in local dialect: "Mom, have you ever had a broken bone before? The doctor is asking you."

Then he said with some embarrassment: "Doctor, this is my mother-in-law. After I got married, she has been in good health, but her leg is not very good, and she has never had any surgery."

The patient understood what his wife said, raised his head and said, "The bone is broken?"

"Bones were broken. It was so young, teenagers. I was still a girl."

"At that time, I was working in my hometown, and I fell down. Later, the doctor in the village took care of my fracture."

"Doctor, how do you know that my bone is broken?"

"I personally almost forgot about it."

"You guys are amazing." Luo Yun and the others could understand most of what the patient said.

The patient immediately held Zhang Zhengquan's hand, pinching Zhang Zhengquan so excitedly that it hurt a little.

When Zhang Zhengquan heard it, I rely on (‵o′)!

It was really broken!
"It's seen on the film. I'm a woman." Zhang Zhengquan could only reply like this.

But when he went back to read the film seriously, he was a fool!

The film did not write the word traumatic arthritis!

Is it traumatic arthritis if the joint is deformed?
What's the matter?
Luo Yun said: "You are her daughter-in-law, right?"

"Yeah!" The middle-aged woman nodded.

"Her current situation is very serious. She can no longer walk. You just saw that every step she takes is a torment."

"To be honest, I admire her for being able to walk in such a situation now. Your mother-in-law can bear the pain very well." Luo Yun sighed.

The middle-aged woman nodded and said: "My mother-in-law is a person who can endure hardships. My husband and I wanted to take her for surgery ten years ago, but at that time my mother-in-law was reluctant to part with the money and thought she could barely leave, and the doctor at the time Said she was not old enough, said several years of surgery."

"But when I took my mother-in-law to see a doctor recently, my mother-in-law still refused to do it, so I can only bring her here." The middle-aged woman said helplessly.

Hearing this, Luo Yun nodded and said, "Well, I might have been younger before. If I had had surgery then, I would definitely have to have another surgery, so it can be delayed for a few years."

"I can still walk now, which proves that the muscles have not atrophied."

"However, surgery is necessary to recover." Luo Yun said directly.

This is an interesting case, the joint deformation is so severe, how to restore the line of force, how to make up for the shortened length of the affected limb, and straighten the re-deformed joint...

Still a little challenging.

Luo Yun was looking forward to it, his hands were almost sore, if such a complicated initial joint replacement could be his first joint replacement in the department.

It was really comfortable, and there was a feeling of reuniting with old friends...

"Are you going to have an operation?" The old woman stood up in fright, ignoring the pain in her leg.

But she immediately asked the key question: "So? How much would it cost?"

When the old woman asked, the middle-aged woman next to her said, "Mom, sit down first. This operation is not expensive. The doctor told me that it is not expensive."

Then he turned his head to look at Luo Yun, lowered his voice and said, "Doctor, don't tell my mother about the money."

"She is reluctant to part with money." The middle-aged woman said.

"At least [-] to [-] yuan must be prepared. She is going to have a joint replacement, and the joint prosthesis is at least [-] yuan. This will not be reimbursed." Luo Yun said blankly.

Who is not willing to part with money?

"doctor."

"Can our county hospital do this surgery? Should it be cheaper?" the middle-aged woman asked.

She remembered that when she was in the county hospital, the director also told her to do joint replacement, but she had to hire an expert. The money for the expert would not be reimbursed, and she had to pay for it herself. Otherwise, they would go to Shashi to see it by themselves , so as to avoid the cost of hiring an expert.

Luo Yun replied with some embarrassment: "I don't know. I haven't seen doctors in other hospitals, so I can't comment on it. They may or may not be able to do it, and I don't know the cost. gone."

"If it's on our side, it will cost at least 3 yuan to save a little."

"Zhou Cheng, write it down, it is recommended to perform joint replacement surgery. Otherwise, there will be risks of paralysis, muscle atrophy, etc."

After Luo Yun said this, he said again: "In her current situation, taking medicine will definitely not work, you see."

"On the plain film, her joints have completely collapsed, without any joint space, and the bones are grinding against the bones. No amount of painkillers can stop it. Taking painkillers can only make her stomach suffer more damage ...was a waste of money."

"Her current symptoms are that she can no longer walk. As I said just now, every step she takes is suffering for her."

The face of the middle-aged woman immediately changed, paralyzed?

Quickly asked again: "Then how long will my mother-in-law be paralyzed if she doesn't have an operation?"

"I can't judge this. If she doesn't move after she goes back, it may be the same as now, but if she doesn't move, then it's not much different from being paralyzed." Luo Yun can't guarantee, who can say about this matter Accurate?

"After the operation, will she be able to walk? Will she have to use a wheelchair or use crutches?" She then asked.

"Then if she still needs to use crutches or a wheelchair after the operation, I will definitely not do it for her." Luo Yun was very happy.

"People who are paralyzed can still move in electric wheelchairs. With the money for surgery, they can buy several wheelchairs."

"In her current situation, the prognosis of the operation may not be very good, but as long as she recovers well and exercises well after the operation, she will not be able to tell the difference in her walking posture from the old lady outside." Luo Yun replied confidently. road.

"It's definitely not a problem to take the grandson, cook, buy vegetables, wash clothes and other simple housework."

Luo Yun said pointedly.

The middle-aged woman's eyes lit up immediately after hearing this: "Thank you, doctor, I will think about it!"

After she finished speaking, she was about to open the phone's address book, as if she was going to make a call to ask someone.

But after hesitating for a while, he said directly: "Oh no, doctor, just give me a hospital certificate. I will take my mother-in-law to the hospital. I will perform the operation on her."

Luo Yun pouted his mouth towards Zhou Cheng, and Zhou Cheng hurried to write the hospital certificate, and gave Luo Yun a thumbs up in a bit dumbfounded.

Then Luo Yun said to the middle-aged woman: "You have to think carefully and discuss it with your family. Surgery for the elderly still has certain risks, and the cost is quite high."

"It's not as simple as going to the vegetable market to buy some vegetables." Although Luo Yun wanted to carry out the first joint replacement surgery in the department, he would not go for surgery just for the sake of surgery.

"Well, okay. Dr. Luo, I will discuss it with my family." The middle-aged woman said seriously.

Just now Luo Yun said a reason that she couldn't refuse.

My own mother-in-law, after the operation, was able to walk well, wash clothes, cook, and buy vegetables. For her, it was more than half of her liberation.I can also go to work well, and there are people to pick up and drop off the cubs.

Seriously.

"Then you can go to the second orthopedic ward to make an appointment later, and you should be able to be admitted to the hospital soon!" Luo Yun said, looking at the old woman and sighing.

When I am old, I have spent my whole life running around for my son, bought a house and a car, and in the end, if I have no money, I don’t even have much say in seeing a doctor for myself.

This is a living fact.

However, this daughter-in-law is quite filial. Although the reason he gave was just right and hit her heart, she agreed to the operation without hesitation.

However, it is enough.

It's not in vain to spend a little thought on myself.

The old man is pitiful, and her daughter-in-law's clothes don't look like people who are short of money.

"Mom, let's go first and make an appointment in the ward. Your legs are useless after taking medicine." The middle-aged woman explained seriously.

"Are you going to be hospitalized for surgery?"

"It will cost a lot of money, I won't do it, it's too expensive, I won't do it!" What Luo Yun didn't expect was that the old man shook his head resolutely rather miserly, and even fled the consulting room tremblingly.

"We are the sons and grandchildren of money matters. Don't worry, your health is the most important thing."

"We planned to let you do it a few years ago. You said it was expensive. At that time, we had just bought a house, and it was true that we didn't have that much money. The money was valuable at that time, but now, your grandchildren's tuition fees for a year will cost a lot. several thousand."

"They also hope to take you to the amusement park to play together. It won't cost much."

"Even if you feel bad about money, just treat it as spending money to accompany Zhou Zhou and Lan Lanhua, isn't that okay?" The middle-aged woman comforted her mother-in-law...

Only then did the old man move.

"How much will it cost?" The old man looked up and asked.

"It's not expensive, it's only over 1!" After speaking, he winked at Luo Yun.

It seems that he hoped that Luo Yun would help her keep it a secret and not expose it.

The old man lowered his head and murmured: "More than 1, more than 1, we were able to afford several big houses at that time, and I have only earned such a little money in my life..."

"Mom, that was when you were upright, and your legs were bad. Now the money is worthless." Then, she took her hospital certificate and prepared to help her mother-in-law to the inpatient department.

Luo Yun quickly suggested: "Sister, help your mother-in-law out and sit first, then go down and rent a wheelchair, and push your mother-in-law to the inpatient department. She is walking now, and it really hurts."

The middle-aged woman's eyes lit up immediately, and she said, "Okay, thank you doctor, you are such a good doctor."

After finishing speaking, she turned around and helped her mother-in-law out of the consulting room.

Looking at the backs of the two, Luo Yun murmured in his heart, it seemed that he had misjudged the person!
It turned out that it was not the daughter-in-law who was reluctant to undergo surgery, but the elderly who were reluctant to part with money.

……

After the person walked out, Luo Yuncai looked at Zhou Cheng again, his mind was turned.

It was a surprise that Zhou Cheng could see traumatic arthritis. This is quite professional joint surgery knowledge.

It seemed that Zhou Cheng had pretended it again.

However, after being admitted to the hospital, Zhou Cheng, you have to see it.

Consultation and treatment are two different things.

However, is it possible that Zhou Cheng is not deep enough to understand the difficulty of this operation?

Luo Yun's thoughts moved to other places again.

Zhou Cheng was also looking at Luo Yun, his heart fluctuated——

Teacher Luo must be too powerful. After the first patient came in, he explained clearly in a few words, and now he even got the patient's family to agree to the operation with a few words.

Zhou Cheng also knew that the patient had to undergo surgery, but the doctor only had the right to suggest how to persuade the patient to go in the most favorable direction.

This is not something that can be explained clearly in one or two sentences.

This is trying to figure out people's hearts!

Take grandchildren, cook and wash clothes...

Are these things relevant to the medical profession?It has nothing to do with it at all, and it doesn't reflect a person's medical professionalism at all.

but?
Just these few words just moved the heart of the patient's daughter-in-law.

Before he had time to speak, Zhang Zhengquan asked Zhou Cheng: "Brother Zhou Cheng, how did you see that the patient had a fracture just now? Can you tell?"

Zhou Cheng turned his head and said to Zhang Zhengquan: "Quanzi, the imaging of X-ray film is actually whether the X-ray can hit the opposite side to form a dark shadow. In this process, the less tissue it passes through and the sparser the density, Then the more shadows you can hit."

"Our bones have a trabecular structure. The trabecular structure is very special, and it will be very neatly arranged when it is born."

"You can experience that the trabecular bone structure is hollow, and it will form a very smooth and complete line-like structure on the X-ray film, right?"

Zhang Zhengquan nodded thoughtfully.

"Yes, there is no fractured bone end, and the trabecular bone structure is complete and continuous. But after the fracture, even if it is fully recovered, the trabecular bone structure will be disrupted and reorganized. At this time, let's look at the previous lines structure."

"You'll find that there's a crossover."

"This is the sign of previous fractures, and it is also traumatic arthritis. The information will be shown to us on the plain film!"

"It's a pity that the film was taken away by the patient, otherwise."

Zhang Zhengquan immediately said: "Brother Zhou Cheng, I'll go get it, the patient is still waiting at the door......"

After Zhang Zhengquan finished speaking, he left the consultation room, and then went to the door of the consultation room and took a few deep breaths.

Inwardly astringent——

Mom, shit, it's really hard in this world now, and it's really hard to make a living.

Zhang Zhengquan's bitterness almost broke with a bitter smile in secret, why should I come to Luoyun Clinic to eat?

This is no rubbish, it's just looking for abuse...

Luo Yun understands, Zhou Cheng understands both, but he himself does not understand, two patients in a row seem to be listening to heaven.

Alas, I don't blame Luo Yun and Zhou Cheng, they came to the outpatient clinic in a good manner, and it was obvious that I had to come here for a meal, maybe it was because I was thinking about my own food and didn't call me.

I?
I am so hard...

After Zhang Zhengquan walked out, Luo Yun sat down, glanced at Zhou Cheng, and said casually: "Xiao Zhou, you have read a lot of books. The review of traumatic arthritis is also from the video. of?"

Zhou Cheng turned his head to look at Luo Yun in astonishment, he really didn't expect Luo Yun to ask such a question suddenly.

Nodding awkwardly and haha: "Angangang..."

I secretly apologize to Luo Yun in my heart——

Teacher Luo, I'm sorry, but I actually licked these, and I even licked you to death.

I will remember you well.

Luo Yun: "..."

The corners of his eyes twitched, thinking that Zhou Cheng was quite hateful.

Watching videos to learn medical skills?

nonsense.

But no flaws were found.

It was installed by him...

……

The third person Zhang Zhengquan brought in was a young man, aged 27 or [-], wearing glasses with black eye sockets.

He is of medium build and looks refined. He should be a clerk in an office, or just engaged in writing work.

However, he walks smoothly on his feet and moves his hands normally.

In his left hand he carried a small file bag.

Doesn't look like a sick number.

Zhou Cheng also took a look outside the door, wondering if Zhang Zhengquan closed the door quickly, blocking the real patients from the door.

Zhang Zhengquan still asked politely: "Hi, what's wrong with you?"

With a smile on his face, the young man glanced at the three people in the consultation room, and saw that Luo Yun was the oldest, passing Zhang Zhengquan and Zhou Cheng.

Directly to Luo Yun: "Hello, doctor."

"I came to you to buy two kinds of medicines. I went to many pharmacies, but I couldn't find them. I asked a friend to find out, and they said that No. [-] Hospital has them. I work in the park, and I don't have time to come here on weekdays. I'm still working overtime today. This is still on leave."

Park is the abbreviation of Star District Industrial Park.

As he spoke, he took out a piece of A4 paper with the name of the medicine written on it from the document bag.

Words are handwritten, quite neat.

Impressively written on it:

Sodium Hyaluronate Injection (Speit).

Hydrocortisone acetate (letter SINE appropriate).

Even the name of the company with the drug is written, it is really detailed enough!
Seeing these two medicines, Zhou Cheng was slightly taken aback.

Sodium hyaluronate injection is a lubricant injected into the joint cavity. Generally, only patients with osteoarthritis can relieve symptoms in the early stage of osteoarthritis.

But if it is used for a long time, it is of no use at all.

Even if it is written in the guide, it is useless. (PS: Here, I would like to warn my book friends, if you go to an orthopedic clinic, don’t use this thing. It’s useless.)
And hydrocortisone is a glucocorticoid, a small amount of oral administration can have an analgesic effect, but if it is taken for a long time, the sequelae are completely unimaginable.

First, gastric damage, and then there are changes in systemic immunity, and then, there are various complications of glucocorticoids.Buffalo back, full moon face, etc...

Who prescribed these two medicines?

Before Zhou Cheng could speak, Luo Yun asked, "Why do you need these two medicines? Is your mother taking them all the time? How long have you been taking them orally?"

The young man forced a smile and asked: "Doctor, it doesn't matter. I didn't come to see a doctor today, so I came to prescribe a medicine. After you finish the prescription, I will leave."

I thought to myself, why do you ask me so much if I have money for you?

However, he still patiently explained: "I asked many friends, and I also checked professional guides on the Internet. These two medicines can treat arthritis. And after my mother took it, her legs and feet are indeed much better. .”

Ok!

Nowadays, with the improvement of knowledge, the simple Baidu medical treatment can no longer satisfy you?

Getting Started Guide to Seeing a Doctor?

Both Zhou Cheng and Zhang Zhengquan were a little nervous, not knowing how to deal with it, they just looked at Luo Yun.

The two of them dare not talk about the guide.

Luo Yun frowned and said:
"Well, you are right. Sodium hyaluronate can indeed prevent the progression of osteoarthritis in the early stage of osteoarthritis. It is also written in the guide book."

"But it's also prevention, just in the early stages."

"Hydrocortisone has also been used in clinical practice for a period of time. It can be found not only on HowNet, but also on pubmed." Luo Yun was annoyed.

"But do you know what are the side effects of these two drugs?"

"Why can't they be used for a long time?" Luo Yun asked back.

The young man frowned again: "I know, it seems to be some kind of glucocorticoid, which can be anti-inflammatory and anti-allergic."

"Doctor, don't ask so many questions. These two medicines were prescribed to my mother by an expert in our county hospital, and she has been using them all the time. Could that expert still harm her?" He also looked at his watch. on time.

"I came here on leave. I really don't have much time. My money will be deducted if I go late."

"If it weren't for the fact that I can't buy it in the pharmacy, I wouldn't come here to bother you. Please do me a favor. After I get the medicine, I have to send it back to my mother. Save me some time."

Luo Yun pushed back the young man's medical card.

Although he also knew that this young man might have to go to work on weekends, and it was not easy to work from nine to five.

However, the first principle of doctors is the principle of no harm!
Apologizing all over his face, he said, "Sorry, I'm sorry, although we have these two medicines here, I can't prescribe them for you!"

"If you're coming to see a doctor, I can show you slowly, and tell me what's wrong with you."

"Why don't you take it? Are you sick?" The young man's voice suddenly increased a bit, joking, I came here on leave, you have medicine here, won't you sell it to me?You think I'm short-tempered, don't you?
"I just asked you to prescribe a medicine. You are a doctor. Isn't what you do just to see a doctor and prescribe medicine? Why don't you prescribe it for me?"

Luo Yun was not stage fright, and explained: "First of all, I am a doctor, and it is one of my responsibilities to see a doctor and prescribe medicine."

"However, you also said that it is to see a doctor and prescribe medicine, not just to prescribe medicine. I have to see a doctor first."

Then Luo Yun explained to him: "You registered my number, the name is yours, that's right. I have a medical relationship with you, and only in this consulting room. When I go outside the hospital, I will see you. It's against the law."

"This is the first point."

"Second, you registered my number, and I am only responsible for seeing a doctor for you. The real-name system for seeing a doctor is also stipulated by the law. It is also illegal for me to see a doctor for anyone other than the registered person."

"Third, the reason why hospitals exist is because the medical relationship must be close, a diagnosis and treatment relationship that takes place in the same space."

"Although cloud diagnosis and treatment are currently developing, I haven't opened an online consultation room yet, so I don't provide cloud consultation services."

"Cloud consultation, you should know, right? I don't have permission to conduct cloud consultation, which is also against the regulations."

"Fourth, based on the principle of no harm."

"The drugs on your prescription are all prescription drugs, although I don't know who prescribed them to you."

"But it doesn't get my approval! I also have the right to prescribe it. So, I don't think you personally need to use these two drugs, so I can't prescribe them for you."

"Fifth, if you don't have any discomfort yourself, just return this number. I haven't been able to provide you with medical services, and I'm sorry to ask for your registration fee."

Luo Yun counted one by one, not in a hurry to get angry.

The young man immediately became angry: "This kind of medicine can't be taken, and that kind of medicine can't be prescribed."

"Then when I took my mother to see a doctor, your doctor used other medicines to cure her? Didn't your doctor prescribe these medicines? You co-authored it to trick me!"

"Are you saying that you need surgery? Do you have any medical ethics? Are you just thinking about earning black-hearted money?"

"I asked you to prescribe a medicine, did it hurt your interests? Didn't it make you earn enough? You won't prescribe it?"

"Do you believe that I will report you?"

Having said that, the anger is up.He has at least a dozen pharmacies.

He didn't find it in a daze, but finally found out that there was such a medicine, and said that he needed a prescription to get it to him.

He registered, but Luo Yun didn't open it yet. Today's orthopedics clinic is just this one.

Besides Luo Yun, who else would he go looking for?

Luo Yun took out his mobile phone without fear, pressed the record button first, and said, "Put your mobile phone away first. Taking pictures and recording are not allowed in the consulting room."

"You can report me! As long as you can find the reason and logic of the report."

"This is your freedom, but I didn't infringe or hurt you, so you have no right to infringe on my portrait rights."

"Otherwise, I will reserve the right to pursue your legal responsibility at all costs."

"Let me say it again, I am a doctor in Shashi No. [-] Hospital. This is a hospital, not a pharmacy. There is only a diagnosis and treatment relationship in the hospital, and there is no consumer relationship between commercial consumers and merchants."

"I don't see patients, I can't see a doctor, I can't diagnose, I can't treat."

"If you need to see a doctor, you can tell your symptoms face to face!"

"I see you to the best of my ability. No one else has anything to do with it."

"Tell me, what's wrong with you?"

After speaking, Luo Yun still turned on the recording.

He said calmly: "Do you have anything else to do next? If not, please leave. You can also go to cancel your account. Can you?"

The young man caught a glimpse of Luo Yun recording, and couldn't help being a little stunned, seemingly frightened by Luo Yun's words.

He gritted his teeth again and asked, "Are you sure you won't prescribe me medicine?"

Luo Yun only said: "I'll say it again. It's not that I don't drive it, but that I can't drive it!"

"And give you a piece of advice."

"If you really believe that I am a doctor and a doctor with professional ability, just believe me, when you see a doctor, you need to see the doctor face to face, instead of buying medicine, you can complete all the diagnosis and treatment relationships. .”

"And if you believe that I am not a psychopath, I believe that our hospital will not let a neuropathy come to the outpatient clinic as an outpatient doctor."

"And if I don't think I'm a slut who likes to scold me."

"You have to believe that if I don't prescribe you medicine, it's not that I'm embarrassing you, but you are embarrassing me."

The young man grabbed the list and left, because there were already security guards hovering at the door.

It's just that after he left the consultation room, he still looked at Luo Yun with hatred.

It is estimated that I am still very depressed.

After he left, Luo Yun sighed slightly: "Oh, it's hard to say that he is not filial, after all, he is not a doctor. It is hard to say that he is filial."

Zhou Cheng and Zhang Zhengquan nodded at the same time.

However, Zhou Cheng also became more respectful towards Luo Yun in his heart.

Luo Yun's words just now are not something that ordinary people can say or think out. It requires level, and it involves skills and understanding of medical relationship, which is relatively thorough.

At least, Zhou Cheng had never heard anything like this from other people.

It seems that I can really learn a lot from Luo Yun's outpatient clinic today.

However, just as he thought about it, Du Yanjun called, saying that there was an emergency dislocated patient in the ward and asked Zhou Cheng to deal with it.

Zhou Cheng explained to Luo Yun apologetically that although Luo Yun was quite reluctant, Zhou Cheng was still on duty anyway, so he couldn't be left behind.

Pretending to be B and then leaving, it's simply hateful...

(End of this chapter)