doctor magician

Chapter 82 Dementia Modes
This case is the grandfather of a middle school classmate of Luo Shuxiang, and their hometown is thousands of miles away from the provincial capital.This incident happened when Luo Shuxiang was an undergraduate student.Xiao Ying was probably still in middle school at that time, so it was impossible for him to know what happened thousands of miles away.

Luo Shuxiang went back to her hometown during the winter vacation and heard about it, but the patient had already died of illness.The patient's family suspected that the doctor's misdiagnosis was a medical liability accident, because she was a medical student, and begged her to check it out.

So she took the patient's family to the hospital to ask the patient's attending physician, checked the relevant medical records as the patient's family, and finally confirmed that it was not a misdiagnosis, because tracheal cancer is difficult to find, and the doctor has done the necessary attention.

It was this case that made Luo Shuxiang have the most intuitive understanding of the harm of tumor diseases, and became one of the motivations for Luo Shuxiang to focus on oncology during her master's and doctoral stages, so she remembers it very firmly.She never told anyone about this case, nor was it reported by any media, nor was it cited in any of the books he read.How did Xiao Ying know?
She didn't believe that Xiao Ying really calculated it through fortune telling, which contradicted her basic common sense of materialism education for many years, but she couldn't explain it.

Seeing Xiao Ying looking at her with a teasing expression, Luo Shuxiang didn't know how to answer for a while, and was unwilling to nod to admit his failure, unwilling to accept this fact that he couldn't accept at all.So, he asked casually: "Then why is it so hard to find tracheal cancer?"

If this question had been asked before, it would have been difficult for Xiao Ying to give Luo Shuxiang a satisfactory answer based on the medical knowledge he had learned at the undergraduate level.But it's different now. When Luo Shuxiang's father, Luo Qingsong, entrusted him to find out why Luo Shuxiang committed suicide, he began to research Luo Shuxiang's relevant information.When he found out that this woman would become a nationally famous oncologist in the future, he read many cases of Luo Shuxiang as the attending doctor with great interest.

And Luo Shuxiang has a very good habit, that is, when she records the medical records, she will write in detail every round of the patient's ward rounds, the thinking process of the consultation and discussion of the disease, as well as the treatment experience and sentiments, as the data preservation, so , gave Xiao Ying the convenience to answer this question.

He immediately used tracheal cancer as the key word to search for related cases after Luo Shuxiang became an oncologist, and quickly found important arguments written by Luo Shuxiang himself in the medical records several years later.

But it still took some time. Luo Shuxiang saw that he had been silent, so she said coldly: "If you can't even answer this question, it is enough to show that your medical level is not very good."

Xiao Ying snorted inwardly, you have already received a Ph. D., I am only an undergraduate, and you specialize in the study of tumors. Is it fair to ask me to answer based on your strengths?

But he didn't say these complaints, just shrugged gracefully: "tracheal cancer is difficult to be diagnosed by doctors. There are several reasons: one is that it is relatively rare in cancer because of the trachea. Patients with tracheal cancer appear The wheezing dyspnea in patients is often misdiagnosed by doctors as bronchitis, asthma or emphysema. Especially when the patient already has chronic bronchial disease, it is more likely to be misdiagnosed. This case just now is like this."

Luo Shuxiang was a little surprised: "Is it all your imagination or the empirical data conclusions you have collected through case studies?"

Xiao Ying said cheekily: "When I was an undergraduate student, my favorite thing was to read medical records. I have read many cases."

"Oh, really?"

"Of course it is true, and you will see that I am very familiar with all kinds of cases."

Xiao Ying wasn't lying about this, because the pathological data of all hospitals in the country since their establishment were stored in his brain memory.Some even have pre-liberation materials.These precious historical medical records have been scanned by the hospital into electronic files and stored in the general database of medical records, thus recorded in Xiao Ying's brain.

Of course, Luo Shuxiang would not easily believe his words, but he couldn't find any reason to refute, so he continued, "Are there any other reasons?"

"The second reason why tracheal cancer is not easy to find is that the clinical manifestations of this disease are not typical. The initial cough, sputum, and blood in the sputum are not specific. In the middle and late stages of tumor erosion and infection, antibiotics can be used. It is effective, so misleading doctors do not go any further. At the same time, the trachea is located in the mediastinum shadow of the chest X-ray, and the tumors in the large airway appear on ordinary X-rays, making it difficult for doctors to find the tumor. "

Luo Shuxiang's eyes widened again, feeling very surprised.

Xiao Ying continued: "Also, the doctor did not carefully analyze the patient's medical history, symptoms and signs, and missed some subtle features with diagnostic significance. For example, dyspnea caused by tumor blockage is usually inspiratory dyspnea, which can be It aggravates or relieves with the change of body position, the cough is generally an irritating dry cough, and the wheezing sound mainly appears in the expiratory phase. At the same time, unexplained coughing up blood and blood in the sputum occur.”

Luo Shuxiang's eyes widened, round and round, like two large longan peeled.

Xiao Ying's smile became stronger, and he continued: "The middle-aged and elderly male patient suffers from chronic bronchial disease asthma, irritating dry cough, and uncontrollable hemoptysis with blood in sputum for more than a month, and inspiratory difficulty without obvious cause. The effect of anti-asthma and anti-infection treatment is not obvious. Tracheal cancer should be considered and bronchoscopy, pathological biopsy, sputum exfoliation cytology examination, CT and X-ray tomography should be performed."

Luo Shuxiang was stunned. She couldn't believe that there was a medical graduate in front of her.Because even she, a doctoral student who specializes in tumors, could not be so fluent and uninterrupted in a short period of time to make such a detailed and comprehensive summary of the reasons for the misdiagnosis of tracheal cancer.Because this question was suddenly thought of and asked by him, it was impossible for Xiao Ying to prepare in advance.

What surprised Luo Shuxiang even more was that in Xiao Ying's conclusion just now, there were some points of view that she, a doctor specializing in tumor research, had never seen in her previous professional papers.Now Xiao Ying's conclusion gave her a sudden enlightenment.

Little did she know that this revelation actually came from some medical insights she had written in her medical records many years later.Xiao Ying just told her the conclusion many years later to her many years ago.

Luo Shuxiang was stunned by this series of surprises, her eyes widened and her mouth opened wide, looking at Xiao Ying in disbelief.

Xiao Ying shrugged his shoulders: "Any other questions?"

Luo Shuxiang continued to remain stupid, as if she had returned to her zombie mode a few days ago.

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Huang Lili took the note written by Xiao Ying, hurriedly returned to the Department of Nephrology of the Second Provincial Hospital, and found Director Qiu of the Department of Nephrology.

When Director Qiu saw her, a forced smile appeared on his face, and he asked, "How is it? Did Master Abbot agree to lend you money?"

Huang Lili did not answer this question, put the note in front of him, and said, "I would like to ask you to do a test for my husband, a bone marrow aspiration. Because someone told me that his disease is aplastic anemia. Do this test If he can be diagnosed, he can be cured, so that the money I spend will not be wasted."

Director Qiu frowned and took a look at the note: "The patient is pure red blood cell aplasia anemia combined with anemic heart failure. The diagnosis can be confirmed by bone marrow aspiration." He threw the note on the table and looked at it. Huang Lili, "Who wrote this thing?"

"It's a... don't care who it is, you just need to check it according to this."

Huang Lili originally wanted to say that she was a fortune teller, but he himself had a natural resistance to fortune tellers, and he also believed that other people, like him, believed that fortune telling was a feudal superstition.Ask her to persuade others with the words of a person she doesn't even believe, and she will naturally resist it.The reason why she did this was only because Master Abbot asked so, she had no choice.So didn't say it.

　happy weekend!
　　
　
(End of this chapter)