"Have you seen this patient?"

"After reading it, because the patient's headache did not improve, although Dr. Tan was reluctant to discuss it, I still went to read it privately, asked about the medical history in detail, did a physical examination, and found no problems."

"Later, for the sake of insurance, I asked Director Ling to go and see it too. Director Ling's results were similar to what I saw. Therefore, since the patient's father has brought it up, I very much hope that Dean Lin will take the time to come back and have a look. ”

"Okay, you arrange it, I'll go back to the ward on Friday morning." Lin Lin immediately agreed. He wanted to see this patient, and he also wanted to take the opportunity to stand up for Ding Feng. Otherwise, everyone can refuse the director's arrangement, and how will they manage it in the future?

On Friday morning, Lin Lin showed up at the neurology department on time.

Under the chairmanship of Ding Feng, the case discussion officially began. At this point, Tan Xiaomin can't escape. Tan Xiaomin's heart is extremely afraid of Lin Lin.

Because he was beaten by Lin Lin, and because his level was really average, he was very afraid of Lin Lin's questions.

"The patient, an 18-year-old man, was admitted to our department because of headache for more than 2 months." Tan Xiaomin began to introduce the medical history.

"The patient had no cause and had a headache 2 months ago. The headache is throbbing, predominantly right-sided, without nausea and vomiting, and is not significantly related to sleep, eating, or exertion. Usually sleep a little poorly, and dream a lot. ”

"The patient has just graduated from secondary school and has no bad habits. There is no family history of similar medical conditions, and there is no family history of hypertension. ”

"After admission, there were no abnormalities in the internal medical system and neurological examination. There were no abnormalities in routine and biochemical tests of the blood, and there were no abnormalities in the noncontrast CT scan of the head. ”

"Depending on the patient's condition, I consider it as neurosis and treat it as neurosis. During my hospitalization, my headaches eased and I slept better than before. ”

"According to Director Ding's arrangement, I invite Dean Lin to come back today to see this patient, and ask Dean Lin to give guidance on diagnosis and treatment." Tan Xiaomin's tone was very consistent with what Ding Feng said.

From Tan Xiaomin's point of view, the patient's diagnosis is clear and the treatment is effective. In this case, asking Lin Lin to come back for a round is simply redundant.

"Before the official rounds, I emphasize two things. First, Director Ding is the deputy director of the Department of Neurology in charge of overall work, which is clearly written in the hospital's documents, and I will repeat it again. ”

Second, Director Ding has the final say on the department's medical, teaching, scientific research and various personnel arrangements. If anyone does not listen to Director Ding's arrangement, any thing that happens as a result, such as medical accidents, teaching accidents, off-duty and off-duty, etc., will be responsible for the consequences. ”

"Not only that, anyone who does not listen to Director Ding's arrangement will not be allowed to participate in the year-end evaluation of the hospital, cannot participate in the annual promotion of the department, and will have to deduct the bonus of the month for disobedient people."

"There are no rules, if anyone can not listen to the director's arrangement, go their own way, and the department will be in chaos. This is something I don't want to see, and I will never allow it to happen, and I hope that all teachers and colleagues will keep it in mind. ”

This is the first time that Lin Lin has spoken in such a stern tone and in such a stern tone after being reborn. The warning is strong.

"Okay, let's go see the patient." Lin Lin didn't have time to take a closer look at this patient, so he had to ask and check it carefully.

When he came to the patient's bedside, the patient's father was already waiting.

"This is our Dean Lin." Ding Feng said to the patient's father.

"Thank you, Dean Lin! Thank you for taking time out of your busy schedule to see my son. Seeing Lin Lin so young, the patient's father was secretly surprised in his heart: the famous "miracle doctor" was so young.

The medical history asked by Lin Lin was no different from that reported by Tan Xiaomin. The difference is that the patient told Lin Lin that his pain was constant, especially when he slept at night, and the pain had been confined to the right temporal region.

For headaches, whether it was Lin Lin in the previous life or Lin Lin after rebirth, they were all highly vigilant. He knew that headache was just a symptom, and behind the headache, there were many hidden causes. Individual reasons, even fatal.

Lin Lin took the ophthalcoscope handed to him by Ding Feng and carefully examined the patient's fundus. The fundus of both eyes of the patient is beautiful and normal, and there are no fundus changes caused by increased intracranial pressure.

Since the CT scan of the head is normal and the fundus is so beautiful, the headache caused by intracranial hypertension can be ruled out. At such an age, such headaches, the most common, are vascular headaches.

However, the patient made it clear that the headache was constant, especially at night when it was quiet. How can there be a vascular headache that lasts for more than a month? This is clearly inconsistent with the clinical manifestations of vascular headache and does not meet the diagnostic criteria for vascular headache.

"Well, at this age, you have to pay attention to the headaches caused by problems with your five senses." Lin Lin was thinking while examining the patient.

The surface area of the paranasal sinuses, without tenderness. The patient's bilateral intraocular pressure was normal. The corresponding site of the greater occipital nerve is not tender.

Suddenly, Lin Lin had a flash of inspiration: ear, otogenic headache? In her previous life, Lin Lin had diagnosed such a case.

Lin Lin immediately asked Ding Feng for a flashlight, first pulled the left pinna outward and upward, and then shone the light of the flashlight into it. The left external auditory canal is normal, and even the reflection of the eardrum can be seen clearly.

Lin Lin used the same technique to pull up the right pinna and shine the light of the flashlight into it. With this photo, the problem arises. Under the flashlight, the patient's right ear canal is filled with viscous, yellowish-white pus.

There is no doubt that the patient's headache is related to a purulent infection of the external auditory canal or even the middle ear. Because the infection has not spread, the patient's systemic symptoms have not yet appeared, and the blood routine is normal.

"Come, one by one, and look at the ears of the sick." Lin Lin issued an order, and the doctors and interns, including Ling Xiaoyun, Zhuo Yiming, Ding Feng and Li Yun'e, lined up, one read it, and the next one picked it up.

After reading it, everyone's face was full of one word: Serve!

After Tan Xiaomin finished reading it, his face was red and white, so he was not embarrassed. Yes, he had always refused to discuss this patient, and he had always thought that this patient was fine. He also thought that he would discharge the patient next week.

After everyone finished reading, Lin Lin let go of his hand.

"Okay, let's go back to the office and have a good discussion." During the whole process, Lin Lin didn't say anything. But the patient's father had already guessed from everyone's expressions that the cause of his son's illness had been found by Dean Lin.