Personal matters

"Now start the case discussion." Guo Huaixiu cleared her throat and signaled Wang Quan to report the medical history.

Wang Quan nodded, and opened the Chart on the table.

"A 26-bed patient, a 28-year-old married woman. Headache and projectile vomiting occurred about three weeks ago. In the emergency department, a head CT examination revealed a 4*5cm space-occupying lesion in the left temporal lobe..."

Everyone in the room listened attentively, and occasionally one or two senior doctors stepped in to ask some relevant questions.

"At present, the patient is diagnosed as a space occupying the left temporal lobe, and the possibility of lymphoma or glioma is considered. It is necessary to further clarify the diagnosis and formulate a surgical plan. The case report is completed."

After Wang Quan finished his statement, he subconsciously turned to look at his immediate boss.I saw Liu Qitong sitting far away in the corner, with his head bowed and his cheeks resting, he didn't know what he was thinking.

Guo Huaixiu ordered the resident doctor to put the patient's head MRI image under the fluorescent light.

"The space-occupying lesion is near the back of the left temporal lobe, and there is local edema, and the ventricle has obviously been compressed." Guo Huaixiu said.

"The main reason for bringing this patient up for discussion is because the family members are currently feeling a little emotional... Director Liu, what do you think?"

Everyone in the office looked at Liu Qitong in unison.

Wang Quan involuntarily clenched his hands tightly—Nurse Xiao Tang couldn't wait for Liu Qitong's operation plan for a long time, so she ran to Director Guo to file a complaint in a fit of rage. Today is not so much a case discussion as it is more like a trial in three sessions.

Liu Qitong was named by Director Guo and slowly raised his head.

"I think we should continue to observe." He said calmly.

Someone was exchanging glances to express surprise, even Guo Huaixiu couldn't help asking, "What's the reason?"

"I just applied for a re-examination of an MRI film for bed 26, and the report should be available tomorrow."

Liu Qitong paused for a while, and then said, "The patient's condition has been stable for two weeks since he was admitted to the hospital, and there has been no further development...We should continue to follow up and observe for a while."

"The space occupation has been clearly found, why wait?" Someone couldn't help asking, "We are brain surgery, we should remove the tumor in time to save the patient's life."

Everyone nodded in agreement.

"Doctor Liu, can you tell everyone about your thoughts in detail?" Lin Zhen asked.

Liu Qitong thought for a while and said, "I suspect the patient is MS."

There was an uproar below.

"What evidence do you have to support that the patient has MS?"

"The diagnosis of MS is too bold, isn't it?"

"This seems to be confirmed by a neurologist, right?"

…………

After the chatter gradually quieted down, Lin Zhen asked a question.

"Dr. Liu, I think you should know that the incidence of multiple sclerosis is not high in Asian populations. Why do you have any reason to suspect that this patient is MS?"

"First of all, the patient had mental symptoms such as memory confusion before admission, but she has now disappeared, and her headache has also improved, and there is no further functional loss. This is consistent with the characteristics of multiple sclerosis with a tendency to self-heal."

Liu Qitong's voice also became serious.

"That's why I asked for a repeat head MRI. If it can be confirmed from an imaging point of view, the patient does not need surgery at all."

"You are very bold." Professor Lin Changmin snorted, "But have you ever thought that once your judgment is wrong, the patient loses the best time for surgery, which will endanger his life."

"Think about it." Liu Qitong stared into his eyes, "So I must be right."

There was another commotion in the office.

"The diagnosis of a disease does not only rely on imaging data, but the symptoms and signs of the patient are also very important." Liu Qitong said word by word, "This is what you often tell us."

Wang Quan's qualifications are low and he has no right to speak, but his palms are sweaty.

Since Liu Qitong gradually came to power, he no longer obeyed Lin Changmin in everything as before, but it was the first time that he confronted Lin Changmin face to face like this.

"What Director Liu said has some truth." Director Guo pretended to cough and finally expressed his opinion.

"But we are doctors after all, and we can't use the patient's life as a bargaining chip to verify the diagnostic criteria." Guo Huaixiu said slowly, "In case something unexpected happens, it's hard to explain to the family."

Liu Qitong was slightly taken aback.

When there is any disagreement, Director Guo generally tends to adopt Liu Qitong's opinion.This is not only an affirmation of his clinical work, but also helps Liu Qitong establish his prestige and let everyone understand his position in the department.

"At any time, we should put the well-being of patients first." Director Guo continued, "The diagnosis of intracranial tumors in bed 26 is basically clear, I think we should arrange surgery as soon as possible... Director Liu, you still have Is there anything to add?"

Liu Qitong clenched his fists, and after a while, finally shook his head.

"No more, everything is in accordance with Director Guo's instructions."

Guo Huaixiu nodded with satisfaction, "That's all for the 26 beds... Let's discuss the next case..."

"Please wait!"

A clear voice suddenly sounded, interrupting Director Guo's words.

Guo Huaixiu looked up and saw Lin Zhen raised his hand and stood up.

"Oh... Director Lin has something to say?" Guo Huaixiu was a little surprised.

"Yes." Lin Zhen nodded, "I think Dr. Liu's suspicion has some basis."

Guo Huaixiu's heart skipped a beat, and she suddenly became a little unhappy.

"I have seen the CT comparison of patients before admission and one week after admission, and the lesions have not deteriorated further." Lin Zhen said, "Besides, the low incidence of MS in Asians does not mean that there is no disease at all. In fact, I read that There are many cases of MS being misdiagnosed as intracranial tumors."

"MS itself can simulate a variety of intracranial lesions, and some of them are indeed difficult to distinguish from gliomas. The only way is to wait."

"You mean..." Guo Huaixiu frowned.

"Since Dr. Liu has already applied for a review of the MRI film, we might as well wait a little longer." Lin Zhen said, "Craniotomy surgery is very risky and traumatic. To be on the safe side, it's better to be cautious. Director Guo, what do you think?"

At the end of the meeting, Lin Changmin walked out of the office without saying a word, without eye contact with Lin Zhen at all.Although Guo Huaixiu had a smile on his face, his expression was a little stiff.Doctors big and small in Corey all tightened their tails and scattered one after another.

Lin Zhen smiled wryly, but again he didn't control his mouth, this time it was good, he pissed off both his boss and his father at the same time.

He sighed secretly, walked out of the office, and was startled by a figure leaning against the door.

"Why did you help me just now?" Liu Qitong looked at him coldly.

"I'm just telling the truth." Lin Zhen settled down.This person is like an iceberg, and he is helpless.

"So, you also think the patient is MS?" Liu Qitong asked.

"Well, half and half." Lin Zhen replied, "In short, this possibility cannot be ruled out."

Liu Qitong looked at him coldly for a while, and finally stood up straight.He nodded to Lin Zhen, and greeted Wang Quan to go round the ward.