The most enlightened doctor

The next Tuesday morning, Yu Zhiming came to Huashan Hospital with dark circles under his eyes and took the suspected ALS patient admitted yesterday afternoon for a diagnostic examination.

This guy is a otaku who is 1.7 meters tall, weighs 170, and is 33 years old.

He claims to be a senior gamer and plays games as a career to make money to support his family.

According to him, he can stay away from home for a month or two without knowing the changes in the four seasons outside.

If it weren't for the muscle atrophy in his arms, which seriously affected his game playing, he really wouldn't want to come to the hospital for a check-up.

Seeing that this guy looked happy and contented himself with playing games, and didn't care about what would happen in the future, Yu Zhiming secretly lamented that he was a typical happy-go-lucky, contented person.

With this kind of mentality, I can go without leaving home for a month or two, but someone with a little more enterprising spirit would definitely be depressed...

The diagnosis of ALS is mainly based on electromyography, in addition to clinical symptoms, plus imaging and neuropathological examinations.

Yu Zhiming was busy all morning. After the patient's various test results came out, he happily found Qi Yue.

"Teacher, the test results are out. The main indications are not met. It is not ALS."

Qi Yue took a stack of examination information and flipped through the images, then nodded and said, "It's definitely not ALS."

He noticed Yu Zhiming's cheerful smile and couldn't help but asked with a smile: "This test result means that your initial diagnosis was wrong."

"You made the wrong diagnosis, why are you so happy?"

Yu Zhiming chuckled and said, "I wish my cancer premonitions were all wrong."

"If it really was ALS, his life would be over. I would be happy to see such a diagnostic error."

Qi Yue smiled softly and asked again: "Since the test results exclude ALS, what is your new diagnosis?"

"Teacher, it's Hirayama disease."

Hirayama disease, also known as juvenile distal upper limb muscular atrophy, is a benign self-limiting motor neuron disease.

Its clinical manifestations are very similar to those of ALS.

Yu Zhiming pointed out the main indications on the electromyogram and magnetic resonance imaging one by one.

"Teacher, his electromyogram shows neurogenic damage, and his cervical spine is obviously recurved."

"I analyzed that this was caused by the patient's long-term unscientific sitting posture, which caused the cervical spine to arch, compressing the spinal cord, thereby causing ischemia and hypoxic damage to the motor neurons in the anterior horn of the spinal cord."

"Based on these test indications, combined with the patient's clinical symptoms, I am sure that he has Hirayama disease."

"The treatment plan is anterior cervical spine internal fixation, combined with postoperative rehabilitation."

Qi Yue nodded with satisfaction and said, "This time, your diagnosis is correct and the treatment plan is OK."

"You can ask Dr. Han to take care of this minor surgery."

After a pause, Qi Yue added another point: "Zhi Ming, although you are my student, there is no need to challenge difficult and complicated diseases at the beginning. You can start with the diagnosis and treatment of common diseases and typical diseases."

"Before you run fast, you have to walk steadily."

Yu Zhiming knew that this was the teacher trying to beat himself up, a little aggressive in seeking success.

He admitted his mistake and said: "Teacher, I know I was wrong. Next time in the outpatient and emergency department, I will choose one or two suitable patients."

Qi Yue also taught: "Medical skills are never quick, and the accumulation of experience must start from one basic case after another..."

Yu Zhiming looked well-behaved, allowing Qi Yue to enjoy the boss's teacher addiction for a while.

Just when Qi Yue waved his hand for Yu Zhiming to leave, he heard this guy suddenly ask a question.

"Teacher, Qiu Yi once wanted to be your student?"

Qi Yue hummed and said, "He came to see me in the year he graduated."

"I rejected him on the grounds that I never accept graduates without work experience."

Yu Zhiming snorted and asked again: "I heard that he is coming back from studying abroad."

"When the time comes, he still has this idea, teacher?"

Qi Yue smiled meaningfully and asked, "Are you afraid that if I accept him as a student, your status will be challenged?"

"how could be?"

Yu Zhiming looked righteous and said, "I wish you could accept a few more students, teacher, so that I can live the life of a senior brother."

"Besides, I've never been afraid of competition."

“When someone chases and urges you, you will be more motivated and run faster.”

Qi Yue chuckled and said, "Even if he still wants to learn from me, I won't accept it."

"Why?"

Yu Zhiming asked curiously, and then continued: "I heard a lot about Qiu Yi last night."

"He has a strong family background, is a top student, and is the number one young doctor. How many people are rushing to accept a student like this."

Yu Zhiming asked tentatively: "Teacher, have you really never had any feelings for him?"

"Or is there another reason?"

Qi Yue said slowly: "For such an outstanding young doctor, it would be hypocritical for me to say that I have not been moved."

"only……"

Qi Yue stopped and warned first: "I'm just telling you this, so don't spread it around."

Yu Zhiming immediately expressed his position: "Teacher, I am very good at keeping secrets and will never talk nonsense."

Qi Yue said softly: "I have seen some of that guy's case diagnosis and treatment plans. What should I say?"

"He was too pursuing risks and surprises. The actual situation is that there is a more reliable treatment plan."

"Thinking about the constant honors and constant news he has received along the way, this should be related to his character and his desire for attention."

"He is not the type of student I want..."

At nearly twelve o'clock in the morning, Yu Zhiming returned to the big office and saw a fruit basket on his desk.

Zhou Mo introduced: "The patient Zhang Zhe sent it."

Zhang Zhe had minimally invasive ICD implantation surgery last Friday. After three days of observation and no abnormal reactions, he was allowed to leave the hospital.

Another patient related to Yu Zhiming, Xu Feng, who had a severe herpes virus attack, was also discharged from the hospital last Friday and returned to a medical institution in his hometown to recuperate.

Zhou Mo continued: "He was discharged from the hospital this morning."

"I couldn't take away the fruit baskets given by some friends and colleagues, so I specially gave you one to express my gratitude."

Yu Zhiming glanced at Zhou Mo and said, "You don't have to say that last sentence."

"What you said seriously lowered my happiness level and the sincerity of the other party."

Zhou Mo smiled and said, "This is normal. When many patients are discharged from the hospital, they will give fruits, flowers, etc. that cannot be taken away to the doctors and nurses."

"I've seen it all, Dr. Yu. Among the fruit baskets he sent out, your fruit basket is the best in quality and the most expensive."

"Look, there are also exquisite small durians."

Yu Zhiming waved his hand in disgust and said, "I don't eat durian. If you like to eat it, take it quickly."

Zhou Mo was not polite at all. In addition to durian, he also took a few other fruits...

At 1:30 in the afternoon, Yu Zhiming received a gift from the General Surgery Department.

Freshly cut off two-thirds of the stomach.

This patient's stomach had been invaded by a tumor, and surgery to remove more than half of his stomach was a desperate move to save his life.

The removed stomach was to be disposed of as medical waste, but to Yu Zhiming, it was like a treasure.

He can do all kinds of destructive tests he wants and observe the pathological characteristics of various parts of the stomach after cancer...

Yu Zhiming stayed in the center's laboratory, enjoying the joy of acquiring knowledge, until he was interrupted by Zhou Mo at five o'clock in the afternoon.

Zhou Mo covered his eyes, not daring to look at the bits and pieces on the operating table.

"Dr. Yu, the vice president of Peking University School of Medicine is here."

"The director wants you to go to his office..."

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