Back in 2002 as a doctor

The air outside was much fresher, Shen Lang took a deep breath, finally got rid of Zhang You, and was finally able to go to the emergency department for two days, so happy!

But before Shen Lang was happy for a few seconds, his cell phone rang.

Alas, Shen Lang sighed in his heart, it must be that Director Han didn't see him, so he called.

What a surprise!

The stubbornness in Shen Lang's heart came up, even if Director Han called, he would not report to them.

Being with Zhang You these days is really suffering, far less comfortable than staying in the emergency department.

Taking out the phone, just about to mute it, Shen Lang saw a familiar phone number.

Zhou Congwen!

He had contacted Zhou Congwen before, originally Shen Lang thought that Zhou Congwen would be among the welcoming crowd, but after careful recollection, he didn't seem to be seen.

"Congwen."

"I see you, look up, 30° to the left in front of you." Zhou Congwen's voice came.

Shen Lang raised his head according to Zhou Congwen's instructions, and immediately found his black red flag car.

Zhou Congwen still understands himself!Shen Lang happily ran over, opened the door and got in the car directly.

"Congwen, why did you pick me up outside." Shen Lang asked.

"Are you sure you will be impatient?" Zhou Congwen said, "Are you planning to stay in the emergency department for a few days and have a good time?"

"..."

"I really don't know what's going on in your mind, what's the emergency department?" Zhou Congwen said, "I can't, standing in the corridor of the emergency department will feel that the adrenaline secretion is too much."

Chapter 1527 Gossip Spirit

"The emergency department is so lively, it's much better than being with Director Zhang." Shen Lang complained, "Congwen, you don't even know how uncomfortable it is for you and Mr. Huang to go back to China first and throw me in Frankfurt. With Zhang You Working together, I might as well be dispatched to the emergency department."

"What's the matter?" Zhou Congwen asked knowingly.

"Zhang You is simply too much. It's not that I said bad things about him. I can't believe that he thinks everything is due to him." Shen Lang said, "Tell me, what does it have to do with him."

"You have also undergone the operation, and you are also one of them. It cannot be said that it has nothing to do with it." Zhou Congwen patted Shen Lang on the shoulder, and comforted him, "It's better to go directly to the hospital and have a meal first."

"You..." Shen Lang stared at Zhou Congwen, "Are you eating with me? Did the sun come out from the west today?"

"I'm leaving. I don't have any impression of the emergency department in the second year of medical school. I'll go to 912 in a few days." Zhou Congwen said with a smile, "Go and see."

"If you don't eat, the plane meal is unpalatable. Now I feel a little sick when I think about eating. I'll take a shower and go to the emergency department when I feel refreshed. You wait for me."

Seeing Shen Lang's anxious face, if he didn't know, he would think he was going to see his girlfriend.

Zhou Congwen didn't know how to describe Shen Lang, and the thought of taking charge of the emergency department was rarely seen in doctors.The emergency department, where is that? It is equivalent to the place where people are dispatched in Siberia.

But Shen Lang was happy, Zhou Congwen watched Shen Lang smile happily when he mentioned the emergency department, he sighed slightly.

After Shen Lang took a shower, the two came to the emergency department of the Second Hospital of Medical University, and Shen Lang finally calmed down.In the corridor of the emergency department, he looked like a cheetah waiting to be hunted, his eyes were shining brightly.

Zhou Congwen looked funny, "Shen Lang, that's why you like this place so much?"

"Don't mention it." Shen Lang said, "No matter how chaotic the emergency department is, it's much better than being with Zhang You and listening to him say those stupid things."

"Tsk tsk." Zhou Congwen sighed.

"By the way, Congwen, when I was in Frankfurt, I heard that something happened to Bai Wuchang again."

Zhou Congwen still remembered that there was a doctor in the emergency 120 nicknamed Bai Wuchang.

It is really too much to give such a nickname to the 120 emergency doctor.

"What's going on?" Zhou Congwen asked.

"A year ago, he took a patient with back pain and came to the hospital for an examination."

As Shen Lang said, he glanced at Zhou Congwen.

"What are you looking at me for?"

"I asked carefully, do you want to listen carefully?" Shen Lang said mysteriously.

"I don't want to, let's talk about the result." Zhou Congwen replied very simply, "I'll talk about whether we want to talk in detail after we talk about it."

"It's just an ordinary patient. He looked ordinary. He came to the hospital for an examination. It was a typical lumbar disc herniation. The emergency doctor also checked very carefully, and only the direct push and raise test was slightly positive."

"and then?"

“腰椎骨质轻度增生；胸12椎体陈旧性压缩性骨折；腰3-4、4-5、腰5骶1间盘膨隆；腰4-5、腰5骶1间盘水平双侧椎小关节积气。”

"Oh, the diagnosis is relatively clear, degenerative changes, intervertebral disc swelling, and bone hyperplasia." Zhou Congwen said, "What happened next?"

"The patient...Anyway, something happened, so I won't talk about it." Shen Lang said mysteriously, "Congwen, tell me what the problem is."

"It's very simple." Zhou Congwen said logically, "A general doctor's physical examination, the lumbar spine examination only focuses on the observation of the lumbar vertebrae and its appendages, the lumbar intervertebral disc, and the condition of the spinal canal, ignoring the observation of the surrounding muscle tissue. It is the main reason for missed diagnosis.”

Shen Lang stared at Zhou Congwen with wide eyes. He didn't understand himself, so he said a few words, and after giving a few "inductions", Zhou Congwen already had a direction.

"Then there is the problem of lumbar spine CT. Sequential segmental scanning and segmental imaging methods interrupt the continuity of the lesion. The bone window of the vertebral body and the soft tissue window of the intervertebral disc are alternately imaged. Single-axis observation results in no continuity of the lesion and a lack of three-dimensional sense. .”

"The most important thing is that many doctors don't have enough understanding of the causes of low back pain in the elderly, which are limited to lumbar spine degeneration, fractures, protruding intervertebral discs, and spinal canal stenosis.

In particular, orthopedic surgeons have insufficient understanding of primary tumors and secondary tumors in the waist, and intramuscular metastasis of malignant tumors is relatively rare, so they lack awareness of this. "

"Since you said that something happened, I guess it must be the intramuscular metastasis of a malignant tumor."

"!!!" Shen Lang looked at Zhou Congwen as if he saw a monster.

"It has nothing to do with Bai Wuchang, don't call him that in the future." Zhou Congwen said, "It's a question of the level of clinicians."

"How do you know so clearly!" Shen Lang ignored what Zhou Congwen said about Bai Wuchang, but looked at him in astonishment and asked.

"I heard from someone that the intramuscular metastasis of the malignant tumor was not seen. The more the treatment was done, the more serious the disease became. Finally, when I remembered that the tumor had spread throughout the body when I was checked again."

Shen Lang fell silent.

"Here, this is the gossip spirit I told you about." Zhou Congwen earnestly enticed.

"I know." Shen Lang sighed, "But you are too awesome."

"What does it have to do with this?" Zhou Congwen smiled, "What you think is a rare disease may be a common disease in my opinion."

Shen Lang glanced at Zhou Congwen, this sentence full of flaws made Shen Lang speechless.

But in the past two years, Zhou Congwen has proved his rich clinical experience with countless cases.Although he always uses the boss or hearsay as a perfunctory, but he can't perfuse his awesomeness.

"So, you're still young."

"You said it as if you were getting old." Shen Lang was not convinced.

"Take it easy." Zhou Congwen smiled, "When you go to 912, you can see the boss every day, and you will know what is really powerful."

"Congwen, does Mr. Huang usually know what the disease is at a glance?" Shen Lang asked with bright eyes.

"What are you talking about, the boss is a human being." Zhou Congwen frowned, "Don't deify the boss."

"hey-hey."

"The boss just has a lot of clinical experience, and he is usually careful enough, so he finds problems that many people can't find." Zhou Congwen patiently guided Shen Lang, "So you still have a lot to go."

There are not too many people in the emergency department, and it is the time of Chinese New Year. If there is no unbearable disease, they will usually choose to procrastinate.

Although it is not as "lively" as usual, Zhou Congwen can clearly see from the expression on Shen Lang's face that this guy would rather squat here for a day, watching the patients and their families walking around, than working with Zhang You Report.

He didn't even realize that he and Director Han had asked for leave in advance.

Shen Lang was looking around when suddenly a Peking Opera singing came from one end of the corridor.

"My son-in-law, take a closer look..."

Chapter 1528

Zhou Congwen was taken aback, the man's voice sounded a bit old, but he sang well and forcefully, as if he was an old opera player who had a professional background and had sung operas all his life.

Shen Lang's attention was also attracted, his ears were erected like antennas, and his eyes were fixed on a flat car at the end of the corridor.

These days, there are not many people singing Peking Opera. Although this person sang a familiar passage, it was a bit strange to hear it in the emergency department of the hospital.

The sound of the flat car rumbled over, but it couldn't suppress the singing of the person lying on the flat car.

Following the flat car, the family members of the patient tried their best to hold down the patient's limbs, or they would jump off the flat car and perform in public because they were afraid of the patient.

Shen Lang had never seen this kind of patient before, so he watched with all his attention.Unknowingly, a layer of mellow luster appeared on Shen Lang's face.

When passing by, Zhou Congwen observed carefully and saw an elderly man with a blue face and cyanotic lips.

This singing voice doesn't match his expression at all, it looks very strange.

After walking by, Zhou Congwen also saw these things. The patient's eyeballs seemed to be a little problematic, protruding outwards. I don't know if he has hyperthyroidism.

Although the old man looked older and not in good condition, he sang with a perfect accent and an indescribable professionalism.

The patient was hurriedly pushed into the emergency room, Zhou Congwen bumped Shen Lang with his shoulder, "Go and ask what's going on."

Shen Lang took the order and left.

In the emergency department, Zhou Congwen did not have as many contacts as Shen Lang.

It has been more than a year since he came to the Second Hospital of Medical University, Zhou Congwen didn't even recognize all the doctors in the emergency department, even the famous "Bai Wuchang", Zhou Congwen didn't know him.

Ask Shen Lang to take a look, Zhou Congwen believes that Shen Lang can ask for the information he needs in the shortest time.

Sure enough, Shen Lang ran back in less than 10 minutes.

"Congwen, the patient is an 83-year-old male patient." Shen Lang reported the report as if he was making a ward round in the hospital, but it was not so formal and a little casual. "I found that I was confused early this morning, and started singing Peking Opera, so I sent him to the doctor for treatment."

"The patient used to be a Peking Opera performer in an art troupe?" Zhou Congwen asked.

"No, this is the strangest point! The patient seldom listened to Peking Opera before, and never sang it." Shen Lang said with eyes full of stars.

Zhou Congwen frowned, his expression serious.

"Five years ago, the patient underwent surgery for rheumatic heart disease in the second year of medical university, and recovered well after the operation. He has a history of hypertension, and has no history of diabetes or tumors."

"Blood pressure 153/60mmHg, pulse rate 64 beats/min, respiratory rate 18 beats/min, all normal. By the way, blood oxygen saturation is 100%."

Zhou Congwen glared at Shen Lang, disgusted with his unprofessional reporting of medical history.

Shen Lang turned his head and said with a smile, "The patient's vital signs are stable, but he just started to sing for no reason. And when I just entered, I smelled a bad smell, and it feels like the patient is incontinent."

Zhou Congwen nodded, concentrating on it.

"Congwen, what do you think is the problem." Shen Lang asked in a low voice.

"Wait until it's checked out."

Regarding Shen Lang's question, Zhou Congwen was still quite cautious.

It was the same in the first place, Shen Lang only mentioned a few physical signs, basically none of them were positive, but... Zhou Congwen suddenly realized a problem when he thought of this.

"Shen Lang, the patient has rheumatic heart disease?"

"The operation is done. Zhang You did it. I didn't ask about the specific operation process. The patient's family said that he was discharged from the hospital after the operation and that he is in good health recently." Shen Lang said, "Do you think it is about the operation? Pulmonary hypertension?"

"No." Zhou Congwen said, "The patient has no history of hyperthyroidism?"

"I haven't heard of it." Shen Lang replied.

Zhou Congwen recalled the picture of the patient walking by just now, and slowed down the picture frame by frame in his mind to recall.

The patient's eyeballs were protruding, although it was not particularly obvious, but Zhou Congwen could confirm this.Not only that, but also slight eyelid edema and congestion.

Suddenly, Zhou Congwen smiled.

"You figured it out? You figured it out!" Shen Lang said in surprise.

The patient Shen Lang didn't have a clue yet, but Zhou Congwen figured it out, which made Shen Lang unacceptable.

"What do you want to understand?" Zhou Congwen asked.

It's disgusting!Shen Lang clenched his fists, hating Zhou Congwen's habit of asking questions knowingly.

"Hey, what's going on." Shen Lang clenched his fists and almost waved them.

"Wait for the test results, the patient's vital signs are stable, don't worry." Zhou Congwen sat down directly, calmly, and rejected Shen Lang's anxiety.

Although Shen Lang was anxious, there was nothing he could do. He walked back and forth in front of Zhou Congwen like an ant on a hot pot.