The most enlightened doctor

After two o'clock in the afternoon, the aphasic girl finally arrived at the Zhizhen Tower accompanied by her family.

This is a fifteen-year-old girl with a long ponytail, an oval face, and a pleasant appearance.

She also brought a letter from Lei Jiahua, a young boy whom Yu Zhiming met at the military health resort.

Two pages of letter paper were packed with words.

Lei Jiahua spent a lot of space introducing the aphasic girl, saying that she was smart, studious, quiet and sensible. She was also very good to him and often gave him snacks.

Seeing this, Yu Zhiming couldn't help but wonder to himself, wouldn't this thirteen-year-old boy have vague thoughts about his classmate sister?

Isn't this too premature?

Yu Zhiming raised his eyes and glanced at the girl in front of him, then continued to read Lei Jiahua's letter.

This kid wrote later that he started to study seriously after returning home, the kind of study that is very serious and serious.

Because he made an agreement with his parents that as long as his final score this semester is among the top ten in the class, he can come to Binhai during the summer vacation.

The agreed goal is to be among the top ten in the class. It seems that this kid's academic performance in the class is not good.

Yu Zhiming read the letter at a glance, then put it away and looked at the girl and her parents in front of him.

Yu Zhiming found that the girl's eyes were clear and she timidly avoided looking at him.

"You are conscious and can make sounds, but you can't speak normally?"

The girl's father replied: "Yes, yes, people are still the same as before. They can study, write, and do housework, but they can't speak and can only make meaningless sounds."

"We couldn't understand it, it was like she suddenly became mute, just blah blah blah."

After a pause, the girl's father continued: "I went to many hospitals and found no problems such as brain damage or brain tumors. No problems were found in the spinal cord and laryngeal nerve examinations."

"The vocal cords are fine too."

Yu Zhiming made a soft sound, pressed the girl's neck with his hand wearing medical gloves, and asked the girl: "Can you recite Li Bai's Quiet Night Thoughts?"

The girl met Yu Zhiming's gaze and nodded.

"Recite it again."

The girl pursed her lips hard, then looked at the nurse, Sun Lin, and others in the soundproof examination room. She mustered up some courage and opened her mouth.

"Oh……\u0026…"

What Yu Zhiming heard was like a foreign language of some minor language. Although it had cadences, tones and falling tones, he just couldn't understand a single syllable.

Moreover, the sound was not only a bit harsh, but also fluted up and down. It was obvious that the girl could not even control the volume on her own.

At the same time, he felt the air rush out of the girl's lungs, pass through the throat, and rush out of the vocal cords...

After the girl finished reciting Jingyesi in a voice that others could not understand, Yu Zhiming also withdrew his probing hand.

"There are no lesions on the vocal cords, and there are no abnormalities in the physiological structure, but there is obviously something wrong with the tension and relaxation of the vocal cords."

Yu Zhiming further analyzed: "Not only that, the airflow rushing out from the lungs also appeared chaotic in terms of spacing and intensity."

"I guess there is something wrong with the brain center that controls your pronunciation or the information transmission center."

The girl's father couldn't help but remind him: "Doctor Yu, we have had examinations in several major hospitals, and there is nothing wrong with the brain and spinal cord."

Yu Zhiming explained: "Maybe the problem is minor and has not been detected."

He then ordered the girl, "You lie on the examination bed. I need to conduct a detailed examination of your brain and cervical spine."

After the girl lay down on the examination bed, Yu Zhiming first conducted a comprehensive examination of the girl's head. After finding no questionable problems, he began to focus on examining the back of the inferior frontal gyrus of her brain.

Here is the main control of the articulatory muscles, responsible for the production of speech. After damage to this part of the brain, the patient loses the ability to speak, but can understand the language of others. This is clinically called motor aphasia.

Judging from the girl's symptoms, the possibility of problems in this area is quite high.

However, to Yu Zhiming's disappointment, he checked several times and found no abnormalities in this part.

Of course, this does not rule out the possibility that the lesion in this part of the brain is too slight or too deep, and Yu Zhiming's detection capabilities are not powerful enough to catch it.

Next, Yu Zhiming focused on examining the girl's cerebellum and the spinal cord protected by the cervical spine.

After checking three times, Yu Zhiming still found nothing.

This made Yu Zhiming a little confused.

Was it his analysis error?

Or is the lesion too subtle or too hidden to be discovered even with his detection capabilities?

In order to avoid any omissions, Yu Zhiming also examined the girl's laryngeal nerves that control her pronunciation.

The focus is on the recurrent laryngeal nerve, which is the nerve that controls movements such as the opening and closing of the vocal cords.

When the girl recited Jingye Si, Yu Zhiming was able to confirm that there was indeed a problem with the opening and closing of her vocal cords.

If there is no problem with the brain control center and information transmission center of pronunciation, it is possible that there is an abnormality in the nerves responsible for specific control.

This step of inspection is not easy either.

There are so many distractions that need to be eliminated.

Yu Zhiming wants to use sound wave positioning to accurately find the recurrent laryngeal nerve among the numerous blood vessels, lymphatic vessels, nerves and muscles in the throat.

He spent some effort to mark the recurrent laryngeal nerve from beginning to end, and then began to explore it section by section in detail...

It's just that after Yu Zhiming's mind was exhausted again, he still couldn't find the abnormal discovery he wanted.

This gave him a headache.

The patient had obvious symptoms, and Yu Zhiming also had a relatively clear analysis and judgment, but careful examination showed no physical abnormalities, which was rare for Yu Zhiming.

In other words, it can be described as rare...

Suddenly, Yu Zhiming realized something. Not finding a problem was also a discovery.

Especially for someone who is known for his ability to see the subtleties.

He reviewed his examination and said thoughtfully to the girl and her parents: "I did not detect any lesions that caused aphasia. There are two possibilities for this situation."

After a pause, Yu Zhiming said slowly: "First, the lesion is too mild and beyond my ability to detect."

"I will arrange for you to go to Ning'an Hospital for an enhanced MRI examination. Ning'an Hospital has the highest resolution MRI machine in the country."

"but……"

Yu Zhiming added: "Before going to Ning'an Hospital, we must first arrange a psychological examination and consultation."

He went on to say: "This involves the second possibility, which I cannot detect, which is aphasia caused by psychological problems, which is another word we often hear, hysteria."

The girl's father immediately questioned: "Dr. Yu, my daughter has always been well-behaved and normal. She doesn't have that hysterical problem."

"Does she look like she has a mental problem?"

Seeing that the other party was a little excited, Yu Zhiming quickly explained: "There is a big difference between hysteria and mental illness. It can manifest as specific physical symptoms."

"A typical case is that someone has a hysterical attack. His eyes are fine and there are no problems, but he just can't see."

The girl's father asked: "Is there really such a patient who has no problem with his eyes but can't see because of hysteria?"

Yu Zhiming nodded and said: "If I can still deceive you, you can search online."

After a pause, Yu Zhiming added: "Presumably because of this aphasia attack, your daughter is under a lot of psychological pressure. A psychological examination and consultation can also relieve her mood."

"I'll connect you with the best psychiatrist."

Speaking of this, Yu Zhiming thought of Geng Ruoqing... (End of chapter)