Conan: The Mechanic

"Do we actually have an easier way to verify the authenticity of pain?" the female student asked. "It's hard for someone who pretends to be in pain to fake the heartbeat it deserves, and we can test it in Haiti. Or do you tend to use this thing to punish that addict?"

"Well, a good idea, first ask them where the pain is, then press on the spot and ask if it hurts more, and then continue to apply pressure quietly. If it's pretending to be sick, then the person is likely to be affected by the afterburner. The pain is so slight that you can't feel it, but people who are in real pain can feel the pain intensify." Gregory nodded. "But these are not infallible ways, such as if the other person is a drug savvy veteran drug addict who has a heartbeat drug on hand, then these tests are very difficult to succeed - which is why the retired police officer is It's always so difficult to investigate. In contrast, my approach is much safer, because it's easier for the other party to retreat, knowing that you're not easy to mess with here."

The female student nodded thoughtfully, while Gregory continued to switch his topic as before. "Let's go back to the second patient, Clang Rose who plays volleyball -- the treatment for her didn't work, in fact at least we thought it didn't work. When we did blood tests, we found she had tactile hypersensitivity. And The blood routine performed in the face of pain found that the blood calcium data exceeded 16 (11 hypercalcemia line, 15 hypercalcemia crisis line) Can anyone give me some possible reasons?"

"Parathyroid adenoma, kidney failure, vitamin D poisoning..." The female student immediately began to give an example, while the male student chose one of them to speak out.

"I think the most likely one is adenoma?" the male student asked. "Check parathyroid hormone and phosphate, then...Tc-MIBI?"

"Well, dual imaging with Tc-MIBI to detect parathyroid adenomas is the most common practice. But in fact the doctor chose MRI for a full detection for some reason and found that her thyroid was very Clean, but the main problem is that she has an osteosarcoma on her thighbone. Fortunately, the final resection did not cause life-long disability, and this case is closed." Gregory nodded, and then jumped the topic again. "After that, let's settle the farmer's business now. Let me ask you first, have you learned how to announce bad news to your family members in class? How did you practice, one person played the doctor and the other played the family member, And then measure your sympathy by something like how close you are to speaking, and then give you practical points? But in fact, sometimes the crueler way of asking can get some unexpected results, like when I tell him You know what he said when he was dying and we couldn't do anything other than help him with pain? 'What about my dog, what's going to happen to him?'"

"He... when he was about to die, he only cared about his dog?" The male student was stunned.

"Yes," Gregory nodded. "If there's any truth in medicine, believe me, it's the golden rule of 'everyone lies'. Everyone lies, and it's all about lying for a reason - telling them in a brutal way that they're about to die. The truth tends to make them panic and expose what they care about most: you'll find out what's important to them, and that might help you find out what they're lying about."

"You mean, about the dog..." The female student responded quickly. "Are you saying that the dog that was so vicious when they were looking for the venomous snake was the culprit, and the sick farmer chose to cover up the dog?"

"It's not bad that you deduced this from my tone," Gregory nodded. "That's actually the case - the dog bit him, but he liked the dog so much that he hid the fact that he was bitten by a dog: his family's dog apparently had a bad track record of biting other people, which Once the incident is reported, it will definitely be executed, so this dog lover is really willing to hide his illness in order to try to save his dog. In fact, we did find it from the dog in the end. The culprit, Streptococcus, and its attack infected the patient with necrotizing fasciitis, which eventually resulted in the patient's amputation and the death of his dog."

Then, Gregory suddenly picked up a few pieces of chalk from the table and started to paint on the blackboard. "Let's go back to the last patient, the addict. Although I understand that you want to expose his so-called cheating behavior, a new situation has emerged, that is, he began to urinate blood, and the specific color is... like this !" He showed the circles on the blackboard filled with red, yellow and brown. "The urine is like this, tell me what your differential diagnosis is?"

When he said this, his spirit seemed to be very excited, and he was quite eager to try. "You (he pointed to the female student) You obviously have a solid foundation, tell me what this urine shows?"

"Blood in urine can be caused by kidney stones, and brown...represents components other than normal urine and blood, that is, waste in the body," the female student replied quickly. "It means his kidneys are failing."

"His kidneys don't work anymore, it's fine, but why doesn't it work?" Gregory turned his back on his cowardly manner and began to walk to the female student with a cane ~www.readwn.com~ in a very stern tone. on.

"Trauma?" The female student's answer was somewhat lacking.

"The case is not mentioned, are you sure this is possible?" Gregory immediately asked again.

"It may be... a situation caused by the drug addict's private injection of Dulantin," the female student suddenly thought of this result that fits the addict's setting. "Is it this one?"

"Is there any other possibility?"

"Uh..." The female student was a little nervous when she realized that the most probable reason in her mind did not seem to be approved by Gregory. "Could it be an infection?"

"Well, so what should I do if the two possibilities of private injection of Dulantin and infection should be dealt with?" The pressure of suffocation. "Life is at stake, tell me quickly!"

"Hot compresses, bed rest and antibiotics!" The female student seemed a little panicked, and her voice trembled as she spoke.

"Is there any other possibility?" Gregory seemed still not satisfied with such an answer. "Come on! Tell me, is there another possibility?"

"..." The female student opened her mouth, but in the end she could only shake her head guiltily. "I do not know."

"You are a piece of shit!" Gregory's emotions were very excited, but he calmed down again after scolding. "Forget it, at least you still know that you are a waste, which means that at least you will not be arrogant."

At the back of the classroom, the corner of the mouth of the boy who came with the girl twitched slightly. "This teacher is so cruel..."

"Yeah, but... I think there is indeed a possibility that they have ignored it." The girl catered to the boy's words, but murmured something softly.