Rebirth of Medicine Practices the World

"Have you seen this patient?"

"I have seen it, because the patient's headache has not improved. Although Dr. Tan is unwilling to discuss it, I still went to see it in private. I asked about the medical history in detail and did a physical examination, but I couldn't find any problems."

"Later, just to be on the safe side, I asked Director Ling to have a look. The results of Director Ling's look were almost the same as mine. So, since the patient's father brought it up, I very much hope that Dr. Lin will take the time to come back and take a look.

.”

"Okay, you make arrangements, I will go back for ward rounds on Friday morning." Lin Lin agreed immediately. He wanted to see the patient, and also wanted to take the opportunity to stand up for Ding Feng. Otherwise, everyone can refuse the director's arrangement.

How will it be managed in the future?

On Friday morning, Lin Lin showed up at the neurology department on time.

Under the auspices of Ding Feng, the case discussion officially began. At this point, Tan Xiaomin could not escape. In her heart, Tan Xiaomin was extremely afraid of Lin Lin.

Because he had been beaten by Lin Lin, and because his level was really average, he was very afraid of Lin Lin's questions.

"The patient is a male, 18 years old, who was admitted to our department because of headaches for more than 2 months." Tan Xiaomin began to introduce the medical history.

"The patient had no triggers and had a headache 2 months ago. The headache was pulsating, mainly on the right side, was not accompanied by nausea and vomiting, and was not obviously related to sleep, eating and fatigue. He usually sleeps a little worse and has more dreams."

"The patient has just graduated from high school and has no bad habits. There is no similar medical history in the family, and there is no family history of hypertension."

"After admission, the internal medicine system and neurological examination showed no abnormalities. There were no abnormalities in the routine and biochemical tests of blood, and there were no abnormalities in the CT scan of the head."

"Based on the patient's condition, I considered it to be neurosis and treated it accordingly. During the hospitalization, the headaches slowed down and my sleep was better than before."

"According to Director Ding's arrangement, Director Lin is invited to come back today to take a look at this patient and ask Director Lin to provide guidance on diagnosis and treatment." Tan Xiaomin's tone was consistent with what Ding Feng said.

From Tan Xiaomin's perspective, the patient's diagnosis was clear and the treatment was effective. In this case, asking Lin Lin to come back for ward rounds was simply unnecessary.

"Before the official ward rounds, I would like to emphasize two things. First, Director Ding is the deputy director in charge of overall work in the Department of Neurology. This is clearly stated in the hospital's documents, and I will reiterate it again."

"Second, Director Ding has the final say regarding the medical treatment, teaching, scientific research and various personnel arrangements of the department. If anyone does not listen to Director Ding's arrangements, anything that happens, such as medical accidents, teaching accidents, and off-duty work

Wait and bear the consequences."

"Not only that, anyone who disobeys Director Ding's arrangements will not be allowed to participate in the hospital's year-end evaluation, and will not be able to participate in the department's annual promotions. Those who are disobedient will also have their bonus for that month deducted."

"There is no rule without rules. If anyone can ignore the director's arrangements and go his own way, the department will be in chaos. This is something I don't want to see and it is absolutely not allowed to happen. I hope all teachers and colleagues will keep it in mind.

"

This was the first time after Lin Lin's rebirth that she spoke with such harsh words and in such a harsh tone. The meaning of the warning was very strong.

"Okay, let's go see the patient." Lin Lin didn't have time to take a closer look at this patient, so he had to ask and check it carefully.

When he arrived at the patient's bed, the patient's father was already waiting beside him.

"This is our Dean Lin." Ding Feng said to the patient's father.

"Thank you, Director Lin! Thank you for taking time out of your busy schedule to treat my son." Seeing how young Lin Lin was, the patient's father was secretly surprised: the famous "miracle doctor" was actually so young.

There was no difference between the medical history Lin Lin asked and what Tan Xiaomin reported. The difference was that the patient told Lin Lin that his pain was persistent, especially obvious when sleeping at night, and the pain had been localized to the right temporal region.

Regarding headaches, both Lin Lin in her previous life and Lin Lin after her rebirth were highly vigilant. He knew that headaches were just a symptom, and there were many causes hidden behind them. Some causes could even be fatal.

of.

Lin Lin took the fundus handed to him by Ding Feng and carefully examined the patient's fundus. The patient's fundus on both sides were beautiful and normal, with no fundus changes caused by increased intracranial pressure.

Since the CT scan of the head is normal and the fundus of the eyes is so beautiful, headaches caused by intracranial hypertension can be ruled out. At this age, the most common type of headaches is vascular headaches.

However, the patient made it very clear that the headache is persistent and is particularly noticeable at night. How can there be a vascular headache that lasts for more than a month? This is obviously not consistent with the clinical manifestations of vascular headache, nor is it consistent with the diagnosis of vascular headache.

standard.

"Well, at this age, we must pay attention to headaches caused by problems with the five senses." Lin Lin thought while examining the patient.

There was no tenderness in the surface area of ​​the paranasal sinus. The patient's bilateral intraocular pressure was measured by hand and was normal. There was no tenderness in the corresponding part of the greater occipital nerve.

Suddenly, Lin Lin had an idea: Ear, otogenic headache? In her previous life, Lin Lin had diagnosed such a case.

Lin Lin immediately asked Ding Feng for a flashlight. She first pulled the left auricle outward and upward, and then shined the light of the flashlight in. The left external auditory canal was normal, and even the reflection of the tympanic membrane could be seen clearly.

Lin Lin used the same technique to pull up the right auricle and put the light of the flashlight in. This photo revealed the problem. Under the flashlight, the patient's right external auditory canal was filled with thick, yellow-white pus.

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There is no doubt that the patient's headache is related to purulent infection in the external auditory canal or even the middle ear. Because the infection has not spread yet, the patient's systemic symptoms have not yet appeared, and the blood test is normal.

"Come on, come one by one and take a look at the patient's ears." Lin Lin ordered. Doctors and interns, including Ling Xiaoyun, Zhuo Yiming, Ding Feng and Li Yun'e, lined up, one after another after reading.

superior.

After everyone read it, one word was written on their faces: convinced!

After Tan Xiaomin read it, his face turned red and white, and he felt very embarrassed. Yes, he had been unwilling to discuss this patient. He always thought that there was nothing wrong with this patient. He also thought about letting the patient be discharged from the hospital next week.

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After everyone finished reading, Lin Lin let go.

"Okay, let's go back to the office and have a good discussion." Lin Lin said nothing during the whole process. But the patient's father had already guessed from everyone's expressions that the cause of his son's illness had been found by Dean Lin.