Neurology ward.

Today is Monday, and it is the turn of the dean to do the ward rounds.

Chen Qi was wearing a white coat and holding a small hammer in his hand, gently tapping his palms one by one, and under the personal leadership of Director Xia, he checked one ward after another.

The dean made rounds of the ward, and the frame was very sufficient, and the dean walked in the middle, surrounded by a large group of white coats next to him and behind him.

The dean is followed by the director of the medical department and the director of the hospital office, then the director and deputy director of the clinical department, followed by the doctors above the senior and deputy senior level, the attending doctors, the general resident doctors, and finally the advanced doctors and interns.

It is very normal to go out for 2 or 30 doctors on a ward round.

Often at this time, you can see the ecological chain of the hospital, who is closest to the president, is often the person with the highest status in the hospital.

Of course, there are exceptions, there are always some doctors who want to behave in front of the dean, so they will also desperately go to the dean's side.

There are also many Buddhist doctors, and these doctors tend to be the last to do the ward's rounds, and sometimes the wards are crowded, and they would rather stand outside the door to breathe.

Of course, it is also possible that these doctors are afraid of being asked, and if they can't answer at that time, it will be the scene of the social death, and it will also leave a bad impression on the dean.

The general dean likes to ask questions during ward rounds to show their authority, and often likes to ask questions of doctors who are positive.

In this way, the process of asking and answering is simple, and it seems that the scene is very harmonious.

But as a second-class dean, Chen Qi especially likes to "embarras" those Buddhist doctors.

Aren't you afraid of being asked questions by the dean? Didn't you deliberately hide behind? The more you are afraid of something, the more it will give you, and it won't scare you to death!

Chen Qi had just finished a physical examination of a patient and his eyes were looking around.

The clever doctor knew that the dean was going to ask a question, so he quickly straightened his chest, Chen Qi silently glanced at these sycophants, and then looked at the end:

"Come, little girl with eyes and ponytails, come here."

The little doctor was about to cry, thinking that I had hidden outside the door, why did he come to call me.

But the dean called people, and it was definitely not okay if he didn't go, so he came to the bedside with a smile that was uglier than crying, and quickly nodded his head:

"Hello dean, I am an intern doctor at Haidong Medical University, and my name is Ye Fen'e."

Chen Qi smiled and nodded, and said in a very 6+1 manner:

"Attention, classmate Ye, I'm about to solve the question, read that you are a student, let me have a basic point, what is a stroke?"

The schoolgirl was so nervous that she trembled:

"The root cause of hemorrhagic stroke is intracerebral hemorrhage, such as hypertensive cerebral hemorrhage, subarachnoid hemorrhage, etc., and the stroke that people say is stroke."

The more nervous you are, the more Chen Qi wants to tease her, deliberately pretending to be a serious question:

"Well, is there only one hemorrhagic stroke?"

"Oh, and there's an ischemic stroke, like cerebral infarction."

"What are the precursors of stroke?"

"This and this, too many, including recurrent severe headaches in fixed areas, lasting longer periods of time, can be accompanied by vomiting; sudden, persistent unilateral ptosis, double vision; recurrent episodes of limb movement, weakness, and slurred speech; recurrent episodes of dizziness, rotation of vision; Recurrent transient darkening of the eyes in one eye, etc. ”

"What's going on with arteriosclerosis?"

"Arteriosclerosis refers to the deposition of lipids on the arterial wall, which not only forms large and small plaques on the wall, but also causes narrowing and even occlusion of the arterial lumen; It can also damage the normal structure and elasticity of the arterial wall, resulting in blood vessel rupture and bleeding. ”

"What is cerebral artery stenosis?"

The more Chen Qi asked, the more addicted he became, this dean's question actually couldn't ask a student, didn't that make it seem that his dean was incompetent? So one question is harder than the other.

The female students were about to cry: "Academy, dean, you, you can't keep holding me alone and asking, you can also ask others." ”

Hehehe~~~ Many doctors in the ward chuckled.

Chen Qi didn't tease her anymore, and said with a smile:

"Don't be nervous, you answered very well, why are you hiding behind, am I so terrible as the dean? Little classmate, you have to keep up with the handsome guys. ”

Hehehe~~~ The laughter is connected again.

This female classmate smiled on her face, but she was scolding and criticizing in her heart: Do you think you are humorous and handsome?

Dean Chen, who thought he was very approachable, walked into a new ward with the support of a group of sycophants.

As soon as he entered, before Chen Qi could humor a few words, the little boy on the hospital bed directly threw the bottle on the table to the ground and scolded:

"Stupid pigs, a bunch of fools, fools."

As he spoke, the little boy twitched a few times, and then quickly hid in his parents' arms, burying his head in reluctance to come out.

Chen Qi was a little stunned, thinking to himself whose unlucky child this was so impolite, but it was impossible for him to be an adult to care about children.

"What's the matter with this kid?"

The attending doctor hurriedly squeezed out of the crowd, holding the medical records in his hand, and began to report his condition.

As the doctor spoke, such a child came to everyone's minds:

The child may move involuntarily, twitching, blinking, pouting, grimacing, contorting the face, shrugging shoulders, shaking the head, saying vulgar obscene or expletive words, smashing things, and even beating up classmates.

Chen Qi had a flash of inspiration in his heart.

Just like grasping keywords during the exam, these keywords can actually rule out many diseases, so that the scope of diagnosis is further narrowed.

Chen Qi already silently had two answers in his heart, but he couldn't be sure which one it was.

The attending doctor also introduced: "The child was treated in seven hospitals, and after ruling out mental diseases, he came to our hospital for treatment, and the report was completed. ”

Every doctor present was thinking about a possible diagnosis in their heads.

Director Xia introduced at this time:

"After being admitted to the hospital, we first perfected various examinations, but both EEG and brain CT showed that they were normal, and we treated it as epilepsy, and it seems that the effect is not significant at present."

The child's father, Zhong Hengyuan, also introduced:

"Hello Dean Chen, since my son's illness, we have also taken him to the provincial capital and Huhai for treatment, and the most common diagnosis of those doctors is Tourette's syndrome, and some doctors think it is mental illness, but in the end they can't find out what the cause is."

Director Xia answered:

"According to the current view, mental illness and epilepsy can be ruled out, if it is just ordinary tics, epilepsy drugs are also adaptable, but after all the drugs are used, the child still continues to have convulsions and other symptoms."

Chen Qi had the answer in his heart, and of course he wanted to remind his colleagues, so he asked:

"It's not just speculation, haven't you found out? Since we came in, in addition to making all kinds of ugly gestures and twitching, this little kid has been cursing from time to time, and even patting the table and quilt and the like. ”

Everyone began to think about it and observe more closely the little boy's "onset" from time to time.

Chen Qi looked at the child's parents again, "How old did your son start to have this situation when he was about to be?" What does it look like at home and at school? ”

Zhong Hengyuan has already answered the doctor countless times, so he blurted out:

"When I started in the first grade of elementary school, I was often complained by my classmates that my son was bullying his classmates, and then when it progressed to class, he would suddenly stand up and speak loudly or throw away his books.

Later, there were cramps from time to time, making trouble, and that's it. ”

Xiao Minghao happened to start twitching a few more times at this time, and Chen Qi noticed that the child's consciousness was awake.

Zhong Hengyuan is still complaining:

"Many teachers and classmates thought that the child was naughty, so they isolated my son very much, and even some teachers tried to physically punish him. Later, my relatives and neighbors also thought that my family Xiaohao had become an undesirable person and was disliked.

But our husband and wife firmly believe that my son is not a bad child, he is sick, as long as he is cured, he will be cured. Dean Chen, you are a famous miracle doctor in Vietnam, better than foreign doctors, please save my child. ”

Pity the hearts of parents all over the world.

Chen Qi was embarrassed to hear it, and at the same time felt happy for this child.

If it weren't for such a reasonable and courteous parent, I firmly believe that my son is sick.

But if other parents abuse and beat their children at every turn because the teacher complains, and do not take the initiative to seek medical treatment, the consequences can be imagined, and the child's condition will only get worse and worse.

If the parent insists that the child is mentally ill and treats him like a fool, the child will be doomed for the rest of his life.

So Chen Qi looked at his parents and comforted:

"Don't worry, we can always think of a way when we get to our Vietnamese hospital, we must first figure out what kind of disease can be treated."

Just when everyone was comforting their families, Xiao Minghao whispered:

"Doctor, I want to go to school......"

Chen Qi also has a pair of 8-year-old twins in his family, so when he saw the 10-year-old Xiao Minghao looking scared and helpless, his heart was moved:

"Your name is Zhong Minghao, right?"

"Yes, uncle."

"You just said you wanted to go to school, right?"

"Yes, uncle, I want to go to school, I want to play with my classmates, but they don't welcome me, they always call me a bad boy."

Chen Qi squatted down and asked, "So Xiaohao, do you tell me that you are a bad boy?" Did you deliberately make trouble in class and beat up your classmates? ”

Zhong Minghao's children's eyes were full of tears:

"I'm not a bad boy, I just can't control myself, and I don't know why I always unconsciously scold and beat people, I really didn't mean to."

Chen Qi nodded lightly: "Uncle believes that you didn't mean it, but you ......"

Before Chen Qi's words were finished, Xiao Minghao became ill again and scolded: "Idiot! Silly woman! ”

Then he turned over and slapped himself a few times at everyone's buttocks, deliberately because you are all big stinky farts.

Chen Qi stood up, watched Xiao Minghao's "performance", and then turned back to the many doctors and prompted:

"I also saw it just now, when the child is conscious, he behaves like a well-behaved person, and even expresses regret and embarrassment for his behavior, although he knows that it is wrong, he can't control his words and actions, do you think this is a pathology?"

The friendly dialogue between Dean Chen and the child just now, as well as the scolding of the child when he became ill, everyone saw it.

At this time, a doctor whispered:

"It's not like a petit mal seizure, which can also have tics and abnormal behavior, but it won't be aggressive, and it won't be full of swearing."

Another doctor was also puzzled:

"The child has no history of head trauma or encephalitis, so it seems difficult to diagnose from the perspective of neurological diseases, and the child's manifestations have far exceeded the clinical manifestations of Tourette's syndrome."

And the doctor said firmly:

"I think it's still a mental illness, otherwise I can't explain that I was still talking softly just now, and then it became foul language again, and this kind of switching doesn't seem like an organic disease at all."

Chen Qi looked at Director Xia Hua:

"Director Xia, what do you think caused it?"

Director Xia chuckled and shook his head:

"This is indeed stumped for me, I have also tried diagnostic drugs, all failed, Dean Chen, I seem to be quite sure of your appearance, why don't you tell us?"

Everyone's eyes were on Chen Qi, and the diagnosis of the divine doctor was always unexpected.

Chen Qi didn't hide it, nodded and said, "There are indeed two diagnoses. ”

"One of them I think is more consistent with Tourette's syndrome, and the other possibility is that Huntington's disease can't be ruled out."

As soon as Chen Qi's voice fell, all that appeared in the minds of both doctors and patients' families was question marks.

Director Xia Hua knew that the dean was well-informed and his knowledge reserve was among the top in the world, so he said with a smile:

"Come, while the parents are here today, and there are so many big and small doctors, Dean Chen, tell us what Tourette's syndrome is and what Huntington's disease is."

Chen Qi was in a good mood, so he stood there and began to tell the story.

"I once saw a movie abroad, and the name of the movie was "Call Me First."

(Actually, this is a 2001 movie, which is not available in this era, but no one has checked this kind of trivial matter, and Chen Qi is also fooling.) ）

"The male protagonist of the movie is called Brad, who is also a schoolboy who has suffered from a special congenital disease since he was a child.

It is a severe spasmodic disorder that causes him to twist his neck uncontrollably and make strange noises, and even in class, he often screams suddenly or knocks over his desk, seriously affecting other classmates.

And this kind of weird behavior made him not understood by the people around him since he was a child.

At school, the teachers often criticized him, and his classmates sneered at him, and even his father was disappointed in his son after educating him three times and twice, seeing that his son did not correct him.

Because Brad couldn't restrain his strange noise, he was considered a bad boy by the school to be undisciplined, not only did the teachers not understand, but his classmates would make fun of him for this behavior.

So Brad's elementary and middle school years were spent in misunderstanding and loneliness.

But his grades have been very good, and obviously intelligence is not affected.

After graduating from college, Brad interviewed for teaching positions at various schools with the belief that every student deserved to be taught and wanted to be a teacher.

But at every interview, the school staff was always suspicious of him because of his strange symptoms, and explicitly told Brad that if he wanted to be a teacher, then he would not be hired if he could not make strange noises during class and do strange actions.

But Brad was sick, and he couldn't control his behavior at all, so he couldn't get a job.

These reasons made him feel frustrated, but fortunately, his mother has always supported him and encouraged him, allowing him to face life bravely and overcome difficulties, and in the process Brad also gained love.

Finally, after interviews with about 25 schools, a primary school was finally willing to hire him as a second-grade teacher with a one-year contract.

And Brad also used his own efforts to prove that he is very suitable for being a teacher, and he wants to get along well with his students, and finally was even selected as an outstanding new teacher of the year.

Brad's life was difficult, and he struggled with illness all the time.

His mother has been cheering him up, encouraging him not to compromise with the disease, and after the pain, he is still optimistic, and he is still brave in the face of the cruel reality, he himself has overcome many difficulties and obstacles, and stubbornly defeated the disease.

Exactly, it's an inspirational movie, but it was this movie that gave me a great inspiration. ”

Zhong Hengyuan said excitedly:

"Isn't this Brad my son, the protagonist in this movie is exactly the same as my son, Dean Chen, tell me, what disease does the child in the movie have? How was it cured in the end? ”

Everyone's eyes suddenly focused on Dean Chen.

Good guy, it turns out that being a doctor not only needs to read a lot of books, but also a lot of movies, can this movie also solve a case and diagnose a case of incurable disease?

Chen Qi smiled, "The movie I'm talking about, the protagonist has Tourette syndrome." ”

"Tourette syndrome?" Obviously, even a director-level doctor like Xia Hua has never heard of it, let alone the patient's family.

Tourette's syndrome, also known as Tourette syndrome, is derived from the French neurologist Jean-Martin Chacoult's name for his intern Tourette, who first discovered Tourette and published a description of nine patients with "convulsive tic disorder". ”

Chen Qishou clicked on the outermost intern who was listening and smiled:

"Did you hear that, the Tourette syndrome I was talking about was discovered by the intern, which means that the intern can also think independently and publish medical papers independently, but hiding in the back like you, and not seeing the patient in person, is it possible to find any unique patients?"

When several interns heard this, their faces turned red.

But not all interns are Buddhist, and some of the more motivated interns took the opportunity to squeeze forward, including the ponytail girl when she asked the question before.

Chen Qi smiled and continued to explain to everyone:

"Tourette syndrome, the name encapsulates well the most severe manifestations of the disease, which are uncontrollable tics and trigrams. Sudden, transient, intermittent movements or sounds are the hallmark sign of Tourette syndrome.

Tics are divided into simple tics, which involve a limited number of muscle groups. Then there are complex tics, which involve several muscle groups. There are many simple and complex tic symptoms found in patients with Tourette syndrome.

Simple tics include blinking, shaking head, shrugging shoulders, eye wandering, nose twitching, mouth movements, grunting, coughing, and throat clearing.

Complex tics include repeating observed movements, touching or smelling objects, walking in a certain pattern, making obscene gestures, bending over or turning the body, jumping aimlessly, repeating words or phrases spoken by oneself or others, or saying vulgar, obscene or expletive words.

Let's take the benefit of hindsight, let's compare this little friend, called, Zhong Minghao, right, parents, you know your son best, think about it, what I just said, is it worthy of your son? ”

Zhong Hengyuan and Du Wenjuan nodded excitedly:

"Yes, yes, Dean Chen, you are like a fairy, you describe my son's condition at all, it is too bad, so is there any risk or danger of this disease?"

Chen Qi heard the affirmation of his parents, and felt a little proud in his heart, he used the knowledge of the previous life to act as a miracle doctor in this life, which was so fucking cool.

However, in order to maintain his superior demeanor, Chen Qi still pretended to smile.

"Normal people may wonder, why can't they control their actions and words? In fact, it really can't, and many patients say that it is like a sneeze for them, and they can't help it.

Before the tics appear, people have an uncomfortable physical sensation, also called a premonitory urge, such as itching, tingling, or nervousness, which is relieved only after the tic episode.

If the condition worsens if you are sick, stressed, anxious, tired or excited, Tourette syndrome often triggers behavioral and social challenges that can damage the person's image.

In addition, the disease tends to occur in childhood and adolescence, so it can also cause other diseases. For example, attention deficit hyperactivity disorder and obsessive-compulsive disorder, which are often confused with Tourette's syndrome, as well as learning disabilities, sleep disorders, depression, etc.

At this point, then we can really describe mental illness, and the process is irreversible, and this is one of the biggest dangers.

Another danger is that many people have not heard of this disease, and naturally they will not think of the child's tic symptoms as a disease, and most people will think that the child has developed bad habits.

Some parents are more patient and will take the trouble to correct their child's behavior or seek psychotherapy. However, some parents may directly use violence to correct the situation.

So I was thinking that Zhong Minghao's child was lucky, because you as parents understood him very well and didn't put more pressure on him.

If you as parents don't understand, the teacher will beat the child as soon as he comes to complain, or very strict requirements that the child must be obedient, otherwise how to punish him, then Zhong Minghao's child's condition will only get worse and worse today. ”

When Zhong Hengyuan and Du Wenjuan heard this, half of the big stone in their hearts was put down, and they were glad that they had not done radical acts to hurt their son before.

Therefore, the role of parents in children's education is really too great, don't beat and scold children at will, including homework and the time to send report cards, all the same. (End of chapter)