The next thing is easier to do, find a way to arrange for the patient to do 24-hour brain wave monitoring, bowel sound monitoring and positioning.

For this test, the patient needs to stay in the hospital, but it is not considered to be an inpatient hospital.

It's just a check.

After a day of monitoring, the patient's 24-hour brain wave data and bowel sound monitoring and positioning have been completed.

Naturally, this matter does not need to be done by Zhou Can himself.

Director Jia temporarily arranged for two interns to monitor the patient's bowel sounds and locate them.

The monitoring of bowel sounds does not take 24 hours, mainly before and about half an hour after meals. However, the doctor who needs to listen draws an accurate positioning map.

This job requires strong expertise.

At the very least, it is necessary to know exactly where the bowel sounds are located.

Using two interns at the same time to do this is also to ensure that there are no mistakes and maximum accuracy.

In the digestive surgery consultation room, more than a dozen doctors sat together for consultations.

Several chief physicians, including the Department of Digestive Surgery, were present.

There are a total of five difficult cases and complex surgical plans, which need to be discussed together and the wisdom of many people can be consulted together.

The first case to participate in the discussion consultation was this case of pseudoenteritis.

"This patient is 17 years old, has diarrhea for more than two years, and the symptoms are highly similar to enteritis in all aspects."

Director Jia first introduced the patient's condition, and then put the patient's examination report and other materials on the public screen.

"That's right, this is a typical enteritis!"

A young deputy chief physician in his forties came to a conclusion after reading it.

"I know about this case, and more than half a month ago, the Department of Gastroenterology invited me to come over for a consultation. Everyone discussed it together for a long time, but they did not find out the real cause. It is almost certain that it is not ordinary enteritis. The patient has been treated in many major hospitals, but none of them have been effective. ”

The speaker this time was Director Xiao of the Department of Digestive Surgery, who is 56 years old and also holds the position of director of the Department of Digestive Surgery.

In terms of diagnosis and treatment level and surgical ability, it is second only to Director Jia.

The deputy chief physician, who was the first to speak, was immediately slapped in the face.

When you're young, you're too impulsive and you're always easy to be slapped in the face.

"It's not ordinary enteritis, what could it be? Is chronic enteritis similar to Crohn's disease difficult to cure? The deputy chief physician asked with a red face.

In his early forties, he was called a 'young man' in the ranks of doctors.

The deputy chief physician's momentum and aggressiveness are quite sufficient.

During the consultation, everyone spoke freely, but there were no scruples.

If nothing else, the enthusiasm of this deputy chief physician is definitely worth encouraging.

"Crohn's disease can be ruled out, but the possibility of chronic enteritis is not."

Director Xiao replied.

"Dr. Zhou Can of this group thinks that the patient has pseudoenteritis. Yesterday, the patient was scheduled to have 24-hour monitoring of brain waves, as well as bowel sound monitoring. Next, I would like to ask Dr. Zhou to introduce the diagnosis idea to you! ”

Director Jia is not sloppy at all.

directly pushed Zhou Can out.

The audience was in an uproar, and the focus of attention was on Zhou Can.

Zhou Can stood up and introduced the diagnosis ideas to many senior doctors.

After the introduction, without waiting for him to sit down, Director Jia then signaled to him, "Zhou Can, now that the monitoring data you want has come out, I will introduce your diagnosis to everyone." ”

After listening to Zhou Can's diagnostic ideas, the doctors couldn't help but think deeply.

For this regular trainee who has made great contributions, several chief physicians have long since stopped treating him as a regular trainee. Rather, it is elevated to the level of reciprocity.

"Through the observation and comparison of brain wave data, I found that the patient's brain wave signal was basically the same as I predicted. It is only when you are asleep that the brain waves tend to normalize. Bowel sounds no longer occur. Indicates that the patient should always be in a state of high tension when awake during the day. This further suggests that there is a correlation between prolonged diarrhoea and mental stress. ”

"In addition, the bowel sounds of the patient after eating, it can be roughly inferred that the food has been initially digested by the stomach, and after entering the duodenum, the intestinal peristalsis speed is much higher than normal. I have reason to suspect that after food enters the intestines, it quickly passes through the peristalsis of the intestines, is excreted to the rectum, and then excreted from the body. The abnormal activity of the intestines is likely to be interfered with and manipulated by abnormal nerve signals. ”

Zhou Can spoke eloquently, based on first-hand monitoring results.

The disease of the patients is a neuropathic digestive disorder.

"As we all know, gastrointestinal neurosis, in fact, is a general term for gastrointestinal disorders and functional dyspepsia. It is a disorder of high-level neurological activity that causes dysfunction of the autonomic nervous system. ”

It is mainly caused by gastrointestinal motility and secretion dysfunction, without histological organic pathological changes, excluding gastrointestinal dysfunction caused by other systemic diseases.

"If this patient's condition is unveiled, it is highly similar to neurogenic digestive disorders."

After Zhou Can announced his diagnosis, the other doctors fell into deep thought again.

"Although your analysis is very reasonable, and there is a certain basis to support it, you still can't diagnose this disease!" It was the 'aggressive' deputy chief physician who was the first to question it.

"It's not that hard to get a diagnosis. Patients can be given psychotropic drugs to relieve mental anxiety and wait until the patient's brain waves are stable before the patient is allowed to eat. Then observe whether the patient's intestinal peristalsis rate returns to normal levels. ”

Zhou Can had already thought of further testing methods.

If this little problem could still stump him, three months in the intensive care department would have been in vain.

Learning how the three major systems of the human body work, and practicing them, allows him to have an in-depth understanding of each system.

"I think it's worth trying."

Director Xiao's eyes were bright.

Zhou Can's diagnostic ideas, and even experimental methods, are eclectic.

"Prescribe the patient immediately and see how well the treatment works."

Director Jia directly handwrote a prescription and handed it to Qiu Hong to execute.

……

As the consultation was about to end, Qiu Hong ran back with an excited face.

A smile on his face.

"Director Jia, after administering medicine to the patient, wait for the patient's brain waves to stabilize and then let him eat. Forty minutes later, the patient's intestinal peristalsis was still normal, and for the first time, there was no more diarrhea. The family members were overjoyed, and said that our hospital is worthy of being the most famous hospital in the province, and praised you and Dr. Zhou for their superb medical skills and being a living doctor! ”

Qiu Hong's face was full of pride when she said this.

After preliminary tests, it has been basically proved that the patient's enteritis is really related to high mental stress.

Now no one questioned Zhou Can's diagnosis.

When they looked at Zhou Can, their eyes were full of appreciation or admiration.

The shock is not enough, because it is not the first time that Zhou Can has made such a great achievement.

There have been many cases of incurable diseases that have been 'diagnosed and cracked' by Zhou Can.

"My credit for this case is very small, mainly due to Zhou Can." Director Jia is a very down-to-earth person who never competes with his doctors. "Zhou Can, now that the patient's illness has been basically confirmed, it is really a mental illness, let's talk about Ling's treatment plan! What I would like to hear is to cure as much as possible, rather than relying on psychotropic drugs to control the disease for a long time. ”

Director Jia is half of his teacher.

When he made a request to him, it was completely the tone of the elders to the juniors.

With Director Jia's teaching and cultivation of Zhou Can, he really has this qualification.

From another point of view, it can also be considered that Director Jia and Zhou Can have a close relationship.

"In order to be cured, it is necessary to find the cause of the patient's high level of stress. Through the description of the family, I suspect that the patient's high mental stress is related to the high school entrance examination. Because when the patient became ill, it happened to be in the second half of the third year of junior high school, which was close to the time stage of the high school entrance examination. The cause of high mental stress in children during this time period is relatively easy to investigate. I want to talk to the family and the patient again, and then make a treatment plan accordingly, do you think it's okay? ”

During this time, Zhou Can was making up for the basic knowledge of psychological medicine.

This is where it comes in handy.

He suspected that the patient's high mental stress was probably related to the high school entrance examination.

Even if this is not the reason, it should be relatively easy to troubleshoot.

For example, if the relationship between the parents is in a situation, or the child is stimulated by the early love, or the teacher criticizes the child harshly because of something, it may cause the patient to be highly stressed.

As long as the patient's heart knot is untied, the disease will not be cured by itself.

"You hurry up, I'm looking forward to the final result!"

Director Jia asked Zhou Can to quickly communicate with the patient and his family.

……

Zhou Can was outside the brainwave monitoring room, and easily found the family with a smile on his face.

The cause of the child's illness was found, and the condition was initially controlled after medication, which made the family happy. Most of the sadness on his face has been swept away, replaced by a smile from the heart.

"Dr. Zhou, thank you for saving our son, you are the benefactor of our family!"

When the family saw Zhou Can coming over, they excitedly stepped forward to thank Zhou Can again and again.

"I am only an assistant in diagnosing and treating your son's disease, mainly due to the credit of my teacher, Director Jia. Now I want to talk to you about the specific causes of your child's illness. Aim to be able to cure your child's illness completely, rather than always using medication to control the condition. ”

Zhou Can didn't pick a place, just sat down on the bench outside, and chatted with his family.

"Before the child's illness, did you put pressure on him to take the high school entrance examination? For example, I want him to be admitted to a good high school and so on. ”

"Yes! At that time, the high school entrance examination was approaching, and the child's father emphasized more than once that he hoped that the child could be admitted to the first middle school in the county. Because the child is the only seedling in the family, and the academic performance is not bad, the couple has high expectations for the child. Could it also cause my son to get sick and have diarrhea? ”

The family did not question Zhou Can.

Instead, I felt a little unbelievable.

No wonder they can't understand it.

Without professional medical knowledge, who would have thought that giving children some pressure on the high school entrance examination would actually cause diarrhea in children? In their opinion, diarrhea can only occur if they eat something unclean, or if they are sick.

"I'm not 100% sure yet. Can your son communicate with you normally now? ”

Zhou Can had asked patients questions when he was in the outpatient clinic before, but he couldn't communicate normally at all.

Patients have autistic tendencies.

At that time, I thought that the patient's body was seriously ill, so it led to autism.

Only now do I understand that he may have been autistic because of mental illness.

"Yes! When there are no outsiders, I talk to my son, and he responds to me more normally. It's just that our son has been more introverted since he was a child and doesn't like to talk much. ”

The patient's mother said.

"As long as someone can communicate with the child properly, that's a good thing. You can try to talk to your child and show him that getting into a good high school is not that important. Untie the knot in his heart as much as possible and get him out of the mental cage he has set for himself. ”

Next, Zhou Can specifically taught the patient's mother some persuasion directions.

It is not difficult to provide patients with a private space that is as stress-free as possible. Just close the curtain above the monitoring bed and block the entire bed inside.

According to Zhou Can's instructions, the child's mother went in to try to do ideological work for the child and enlighten the child.

If it really doesn't work, then they can only let them take their children to do special psychological counseling.

Less than half an hour later, I heard crying from inside.

The child's father was already anxiously waiting outside, but when he heard his son crying inside, he immediately wanted to rush in to find out.

was pulled by Zhou Can.

"It's a good thing that a child can cry. I'm afraid that he will hide all the pressure in his heart and bear everything silently. Also, after you see your child, you want to take the initiative to show him that you don't need him to get into a good high school, and don't put pressure on him. Give as much care as you can. ”

For a seventeen-year-old, crying is the first manifestation of a tear of psychological defenses and a complete release of emotions and stress.

This cry also means that the child's heart knot is collapsing.

It's a good thing.

Zhou Can is very busy, and it is impossible to stay here all the time.

After a few words, I went about my own business.

It was about one o'clock in the afternoon, and he was writing medical records in the office and checking information.

The father of the boy was found.

As soon as you enter the door, you have to kneel on the ground.

Frightened, Zhou Can hurriedly got up and held him up, and the other doctors also watched all this in amazement.

"Thank you, Dr. Chow...... My child ate most of the bowl of rice and a lot of vegetables at noon, and for the first time in more than two years, he called me out. Also, after he finished eating, he didn't have diarrhea again, which is incredible. If you save my son, you will save our family, and if my son dies, my family will be ruined. ”

The man's voice choked several times.

For the vast majority of families, children are their hope and life.

"Haha, that's great! Seeing the patient's condition improve and recover is the most gratifying thing for our doctors. Your child's body is very thin because of long-term malnutrition, and you can't expect to feed him a fat man with one or two meals, you need to take it step by step and take your time. We must not immediately give him all kinds of nourishment for big fish and meat, but must gradually improve it. ”

"In addition to the gradual supplementation in terms of nutrition, it is also necessary to help him increase the amount of exercise. When he is able to stand up, take him to move around more and breathe more fresh air outside. When Director Jia comes, I'll help you ask and see if you need to prescribe medicine. ”

When Zhou Can heard the good news, he was happy in his heart.

Finally, he successfully treated a patient with an incurable disease who was on the verge of death.

[Pathological diagnosis experience value +1.]

[Congratulations on successfully diagnosing a very difficult case, and reward pathological diagnosis experience points +100.] Rewards First Aid Wisdom XP +100. 】

Zhou Can reaped two big rewards at the same time.

[Congratulations on your first aid intelligent medical skills have been upgraded to intermediate, with a current experience value of 1/10000, you can multiply your wisdom when rescuing patients, your mind is highly calm, and your diagnostic thinking has been improved by 100%. 】

This special medical skill was successfully promoted to the intermediate level.

Zhou Can was very pleased.

The usefulness of special medical techniques is different from ordinary medical techniques, it is more like spring rain moisturizing things silently.

secretly and silently improved Zhou Can's diagnostic ability and helped him keep a cool head. Able to see the clouds and see the sun, not to be confused by the manifestations of some diseases.

A 100% increase in diagnostic thinking is equivalent to a doubling of the number of ideas.

According to his understanding, it should be to double the diagnostic capacity when diagnosing critically ill patients.

Whether this is the case or not will need to be found out next time I find a patient to experiment.

(End of chapter)