"The patient's condition is not particularly ideal, and the main thing is that he is not cooperative. "Professor Zhang Zhifu has obviously been here for a while. According to him, Professor Zhang was on the scene when the patient was first admitted to the emergency department. "From the moment he was first sent over, the whole person seemed very irritable. ”

In all fairness, it is unlikely that any patient who is forcibly brought to the hospital by his comrades in the police is emotionally stable. — especially after seeing the restraint belt that binds each other's limbs. But Cao Zhiquan's problem is clearly not just "irritable".

The entire rescue room was filled with Cao Zhiquan's howls. Even though the doctor on the side had given him 2ml of cediapam intravenously, he was still howling in horror and anger.

Anyone with normal judgment ability can make the judgment that "this person has a brain problem" from Cao Zhiquan's howl. Normal people don't shout "I'm not sick!" and "Someone is going to kill me!" in the hospital, and more importantly, normal people don't shout for a few minutes and then suddenly stop shouting and have a convulsion.

Sun Lien shook his head after observing Cao Zhiquan for a moment, "This kind of manic situation is not suitable for our department......"

At present, the comprehensive diagnosis centre has a relatively sufficient number of doctors, but the number of nurses is still insufficient. Once encountering a manic patient like Cao Zhiquan, the manpower of nurses is even more scarce - not only because of the lack of nurses, but also when taking care of such patients, the first choice should of course be male nurses, but now there are only male nurses in the comprehensive diagnosis center Xiao Guo.

Relying on other female nurses to look after this 44-year-old patient is prone to various risks and problems. That's why Sun Lien has such a saying.

"There is a shortage of nurses, and that's a problem that can be solved. Professor Zhang looked at Sun Lien and said seriously, "His condition may be the one that is difficult to solve." He said as he pulled out a thin piece of paper, "This patient may not be as interesting as I thought at first - I only knew that he was prescribed citalopram by the Psychiatric Center, but I didn't see the diagnosis from the Jingwei Center." Their diagnosis was 'somatization disorder'. ”

When Cao Zhiquan was sent to the Fourth Hospital, he didn't even have an ID card on him. It was only after the police comrades obtained his fingerprints that Cao Zhiquan's identity was determined. And the doctors of the Fourth Hospital obtained his diagnosis data with this identity information ten minutes ago.

Somatization disorder?Sun Lien frowned, this is not the same as what the status bar says.

Somatization disorder is a term that has only recently begun to be widely used in recent years, and it is the name of a syndrome with variable symptoms. Patients with somatization disorder are extremely worried about their own health and continue to see the doctor more than once. Most of the results of doctors and related medical examinations are "safe and sound". Even if there are occasional tests to support the patient's condition, these tests do not explain why the patient is so distressed and anxious – most of the time they are very mild and early lesions. Generally speaking, such lesions do not cause any serious reactions. Even the "discomfort" should be small or even non-existent.

If it wasn't somatization disorder, what was it that led to Cao Zhiquan's diagnosis of "somatization disorder"? Why did the doctors at Jingwei decide that his problem was mental rather than physical?

"Jingwei Center and we don't use the same system, I asked our doctors here. They said they had to ask the staff of the medical office to retrieve the medical records. Professor Zhang responded to Sun Lien's question, "It will take a while for the detailed case to be available...... He looked at Sun Lien's deep brows and asked tentatively, "Do you want to accept this patient?"

"Yes. Sun Lien nodded, he was a little worried about the patient's condition. At least from the prompt in the status bar, it can be determined that "somatization disorder" should be a misdiagnosis, Cao Zhiquan is indeed sick, and this disease has not been taken seriously by doctors. After many diagnoses and examinations, the doctors who really did not find the problem finally diagnosed Cao Zhiquan with "somatization disorder".

If left alone, Cao Zhiquan will definitely not get the treatment he deserves, and will continue to be treated as a further development of depression. When the time comes, he will not continue to scream and scream, but the original disease will not improve in any way, but will continue to worsen - antidepressants will not have any therapeutic effect on subacute dementia and generalized muscle spasms.

Professor Zhang Zhifu looked at Cao Zhiquan who was lying on the hospital bed with some curiosity, still shouting. He didn't quite understand what had changed in Cao Zhiquan to make Sun Lien suddenly decide to take him in. But at least Dr. Sun doesn't look like the kind of doctor who would take in a patient he can't handle because of a senior doctor's advice.

"Then take it. After a few seconds, Zhang Zhifu said seriously, "This patient's situation may be more complicated, Dr. Sun, you may have to work a little harder." ”

"In this line of work, hard work is common. Sun Lien replied with a smile, he turned around and looked at Cao Zhiquan on the hospital bed who was a little tired because of the gradual effect of sildiam, "As long as there can be a good result, it is not hard." ”

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By the time Cao Zhiquan was admitted to the inpatient department of the Comprehensive Diagnosis Center, it was already one o'clock in the morning of the next day.

Cao Zhiquan's wife and son rushed to the emergency department at around 11:20 p.m. Sun Lien and Professor Zhang Zhifu received the mother and son together.

"That's what your father ...... How long has he been uncomfortable?" It is Sun Lien's job to ask about his medical history, and Sun Lien himself is good at finding the basis to support the judgment of the status column in the questioning, "Does he have a relatively large personality change?"

"My dad used to have a good temper. Cao Zhiquan's son is dressed quite in line with the positioning of young people, a little bit of a slightly killing Matt style clothes. But when it comes to talking, he doesn't have the "spiritual" temperament unique to "spiritual guys". Anyway, Sun Lien listened to him, and felt that the young man in front of him was even a little shy. "When he used to work on the construction site, many of his co-workers said that he had no temper and didn't get angry no matter how he joked. Even if some people go too far, he just tells others not to do this...... I've never blushed with anyone. ”

"But then there was a noticeable change in personality?" Sun Lien continued, "When did it start?"

"Probably ...... It's been two years?" Obviously, Cao Zhiquan's son is not quite sure when his father's personality began to change drastically. "It's been especially noticeable in the last year, when he's been furious over a little thing. The last time I was a little more powerful when I closed the door, he slapped me twice. ”

This change is definitely noticeable enough. Sun Lien lowered his head to record, and wondered in his heart whether this change was brought about by "subacute dementia" or "whole cerebral cortex diffusion-weighted imaging hyperintensity".

"Why did you go to the Jingwei Center?" Sun Lien asked in a different direction, "Have you been to other hospitals before?"

"My dad first went to the hospital because he felt dizzy and didn't have a good memory. Cao Zhiquan's son replied, "Ever since he came back from Dongjiang Province for a year, he has felt that he is particularly dizzy. In the past, he liked to talk to me about things at work, but after he came back that time, he didn't tell me the same things. One would say that he was working as a mason over there, another would say that he was a board supporter, and even said that he was actually going to work as a chef on the construction site...... I asked him how he did it, and he lost his temper. But he remembered everything very clearly. ”

Memory loss, irritability, and may also have mild delusions. Sun Lien's pen paused slightly, and he felt that the delusions and irritable personality in this part might have to put a question mark, not necessarily because of Cao Zhiquan's illness, but also because of the mood swings caused by his memory problems.

Professor Zhang sat quietly on the sidelines, observing Sun Lien's questioning and note-taking methods. And he observed something very interesting.

Sun Lien has only spoken eight sentences and asked eight questions so far. But every question was answered definitely. This is rare in clinical practice.

When taking a clinical history, the answers we hear are basically "no", "no" and "don't remember", which is the most common situation in clinical inquiry. The patient has no underlying diseases in the past, no history of surgery and blood transfusion, and no history of travel...... All in all, getting a negative answer should be the norm.

But Sun Lien did not choose the simplest and most routine inquiry, he directly started from the patient's symptoms and asked the patient's family members relevant questions. At the same time, he received the most direct and at the same time very valuable answer. This type of questioning is very different from clinical practice.

More importantly, Professor Zhang couldn't figure out why Sun Lien asked about the important clinical symptom of "personality change" in the first question. He was very sure that Sun Lien did not know Cao Zhiquan before, and the Fourth Hospital had not received any relevant case reports from the Jingwei Center. But Sun Lien asked about this...... Why is that? Or why?

"Check it...... I don't know. When I went to the Affiliated Hospital of Ningyuan Medical College a few times ago, I was still studying in other places. Later, when I went to Jingwei Center, I went with me, but the doctor at Jingwei Center didn't let me and my mother into the consultation room. I don't know exactly what tests were done. For the first time, Cao Zhiquan's son gave an "uncertain" answer to the latter question.