Medical apathy is a rather serious adjective, completely different from the dictionary definition.

Apathy can mean early shock or damage to the nervous system and a variety of other rare conditions. If a screaming person comes in the emergency flat car, the doctor won't be nervous. But if you push in someone who can open their eyes but don't speak, the doctor will be quite nervous.

Blood pressure 90/55mmHg, indifferent expression...... These two things are connected, and Director Li's whole person is in good spirits. The previous whining was gone, and he felt his heart start beating wildly.

"Mr. Wu, I'm going to explain the situation to Director Han. Director Li eagerly secreted a large amount of adrenaline, causing muscle contractures and pulling the vocal cords, and said in a sharp voice.

After saying that, he hung up the phone and stood up suddenly.

The rapid change in body position led to changes in blood pressure and cerebral ischemia, and Director Li flickered around. He held his hand on the table, held it steady for 3 seconds, and walked out of the office quickly when he felt better.

There were many patients sitting at the entrance of the emergency internal medicine department, and the surgeon was stitching up, but Director Li didn't care about them, and walked quickly to the observation room with a mercury blood pressure monitor.

"Director Han, how are you feeling now?" Director Li asked in a deep voice.

Han Guangyun opened his eyes, as if he was disgusted with Director Li disturbing his sleep, and said unhappily, "I'm fine." ”

"I'll take your blood pressure again. ”

"No, I don't. Han Guangyun said, "How many times have I said that I'm fine." ”

Director Li observed carefully and saw that although Han Guangyun's tone was firm, his voice was slight. According to normal judgment, this is considered "the first recovery from a serious illness", not a big deal.

But if it is applied to the indifference of the expression in the early stage of shock, it can also be explained. The point is that there are no blood test results, everything can only be guessed.

"Director Li, is there anything wrong with Guangyun?" asked Han Guangyun's lover.

"I'll take my blood pressure. Director Li couldn't help but say, grabbed Han Guangyun's hand, and pulled up the cuffs.

"I don't need to say anything!" Han Guangyun was a little angry, he thought that Director Li was over-medicalized and was patting himself on the back.

If you take out one-tenth of the energy of patting your own ass, go to the doctor...... The more Han Guangyun thought about it, the more he lost his energy, and he didn't even have the strength to be angry.

When he was young, he wanted to change the world, and he didn't change his heart until he was middle-aged, at least Han Guangyun thought that his original intention would not change. But it is too difficult to change the world, let alone change the world, even changing the second hospital of the medical university is an impossible task for him.

Director Li rushed to the hospital after work and repeatedly came to measure his blood pressure to show his respect. Han Guangyun not only felt happy, but was tired of it.

He remembered a book he had read called "The Water of the Waves".

The protagonist is an idealist who wants to change the world. He was humiliated, despised, and finally had an epiphany. But in the end, he found that the best floors of the building built by the unit were left to him early, and he didn't want all the houses to be divided.

Now that he is only the head of the medical department, he is not the number one, and he is even 108,000 miles away from the number one, is he already facing these problems?

It's really hard to change this world.

Thinking about it, Han Guangyun felt even more tired, and his whole body seemed to be wrapped in countless ropes, and he couldn't breathe.

Director Li didn't know what Director Han was thinking, so he insisted on measuring his blood pressure. Blood pressure was 90/74mmHg, with no particularly large changes.

This critical blood pressure is definitely not normal, and he believes more and more in the judgment of Teacher Wu Mian Wu.

With his understanding of Han Guangyun, today's performance can be said to be quite "indifferent". But how did the shock come about? traumatic, stressful, infectious, or ......?

Countless possibilities flashed in Director Li's mind, he picked up the mercury sphygmomanometer, gave Han Guangyun's lover a look, and turned to leave the observation room.

Han Guangyun's lover was a little scared, and seeing that Han Guangyun seemed to be asleep with his eyes closed, she hurriedly followed.

"Director Li, what's wrong with Guangyun?" asked Han Guangyun's lover.

"I don't know yet. Director Li said, "You need to do an examination." ”

"Another inspection?" Although Han Guangyun's lover was worried, after all, they were two people, and their thinking was surprisingly consistent, "If you don't do an examination, you won't see a doctor?" ”

Han Guangyun's lover didn't speak loudly, as if muttering to himself, but Director Li heard it clearly.

"That's right. Director Li suppressed the unhappiness in his heart and said, "Director Han may ......."

"Maybe?" Han Guangyun's lover looked at Director Li and asked, "It's just possible?"

She said it three times in a row, and her tone was very heavy.

"Isn't it like there was no auxiliary examination? ”

"You won't see a doctor without a check-up?"

This strange logic has become a dead loop, and Director Li is powerless. Back in his office, he thought quietly for a few minutes. But no matter how you think about it, you can't explain the sudden drop in blood pressure.

He had no choice but to pick up his mobile phone and call the hotline of relatives and friends again to ask for help from Mr. Wu.

After explaining the situation, Wu Mian muttered for a few seconds.

"Mr. Wu, Director Han and his lover said that they would not do any check-ups. Director Li said helplessly, "I can't even ask for a consultation with the whole hospital now." ”

"Let's put it this way. Wu Mian said, "I don't care how to persuade Han Guangyun to do the examination, and I can't do it, but the inspection must be done immediately." ”

"Do you judge that sulfonylureas cause severe hypoglycemia, do you have biguanide lactic acidosis? Do you do arterial blood gas analysis? Metabolic diseases, pH and electrolytes are very important, and blood gas is a must. It's not a question of whether the patient wants to do it or not, it's a clinical treatment standard. Wu Mian said very seriously.

"......" Director Li wanted to cry without tears.

"I have encountered uremia patients who took sulfonylureas and had hypoglycemia, and the patient died after correcting the blood sugar, and at that time cerebrovascular accident was considered.

Rapid correction of hypoglycemia, is there a significant difference in osmotic pressure between the inside and outside of brain cells, and is there a possibility of brain herniation?

Blood sugar 0.54 patients are still awake?

Is a blood glucose of 0.54 a venous blood test or a finger blood glucose?

If end-glycemia is the case, a false decrease in glycemia due to poor peripheral circulatory perfusion cannot be ruled out. ”

"With such a high blood pressure in a hypertensive patient, has cerebrovascular accident been ruled out? If the patient has sudden hypotension, if cardiogenic is not considered, is there a central cerebral stem infarction? What about the electrocardiogram, is there an aortic dissection?"

Wu Mian asked countless questions.

"If you don't do any tests, once your blood pressure drops suddenly, how are you going to rescue it?"

"Teacher Wu, do you really have a problem thinking about it?" Director Li couldn't help it, so he asked in a low voice.

"I met Director Han today, and I didn't feel very comfortable talking to him when I communicated with him, so I didn't say anything serious. Wu Mian said, "Director Li, be careful here. ”