"Well, it's possible that it's tuberculous. Wu Mian said, "The patient will come back from the examination in a while, and I will consult with the respiratory medicine department, please remind ......."

"Mr. Wu, I asked carefully, and recently the patient had progressive weight loss, no night sweats and fever. Director Liang said.

"Wait and see. Wu Mian said, "Director Liang, you are busy first, and I have to go to the senior director of the circulation department." ”

Director Liang was a little apprehensive and confused, he knew that he was not performing well, and he actually missed the diagnosis in front of Teacher Wu.

After symptomatic treatment, the patient does not get better after a few days or has difficulty breathing soon after improvement, and then comes to the hospital for examination and finds that the right chest cavity is full of pleural effusion, how to explain it?

If the patient is kind, he will be fooled and passed. Explained to her that there was cholecystitis first, and then there was pleural effusion, and the effusion appeared in the past few days after returning home, and it was estimated that there was nothing wrong with it.

Although the patient may also understand that something is wrong, one is too lazy to care, and the other is that it is not easy for the doctor, so it passes.

But if you don't understand something, it will be a small trouble to complain directly to the medical department by grasping your own problems.

The point is!

I have heard about some things these days, hesitated, and still haven't made a difficult decision. Mr. Wu probably came to see the situation today, but he didn't expect a patient with tenderness in the gallbladder area to have an accident......

Director Liang was also speechless, and estimated that his idea of going to Bajingzi had come to naught. Although Mr. Wu helped him clear a mine, there are countless such mines on the road of a doctor's life, and there are only a handful of opportunities to change jobs.

Director Liang was very depressed, so he sent Wu Mian and Dean Xue away and continued to go for expert consultation.

Even if you are in a bad mood, you still have to cheer up and deal with one patient after another. How many years of experience there is, Director Liang has not had all kinds of doubts about himself because of the previous incident, and he still sees a doctor how he should see a doctor.

Many doctors will have a suspicion and denial of their mental activities after a misdiagnosis after one or two visits. No matter what you do, you feel that it is wrong, and no matter how careful you are, you feel that you have missed something.

This sentiment is quite deadly.

Some people develop mental illness and sink into it, or even leave the clinic and can only do some other work.

Director Liang is a veteran for many years, and this kind of psychological activity does not exist. He was just very depressed, and kept telling himself that Bajingzi might not be very good, and it was difficult for Mr. Wu Mian and Mr. Wu to push a hospital to glory in a short period of time by himself.

He is almost fifty years old, and Mr. Wu will only be thirty next year, and he has time to watch a hospital grow up, but he can't.

Or in the second hospital of the medical university honestly as his own director, there is no academic future, in the province to carry out ERCP, become the province leader...... One of them, earn some money and retire in a few years.

can only be like this, Director Liang is constantly doing psychological construction for himself to dispel the haze caused by the misdiagnosis just now.

One hour later, the female patient came back with a CT scan of her lungs, and the right lung was 2/3 gone, and the radiograph showed a large pleural effusion.

Really!

After seeing the film, Director Liang did not directly ask the patient to go to the respiratory medicine department for treatment, but asked her to wait for a while.

After seeing the other patients, Director Liang carefully studied the young female patient.

She was twenty-three years old, and her skin was a little white, with some Lin Daiyu-like delicacy and slight sickness.

There is no redness of the cheeks, and there is no blush that is typical of tuberculosis as written in textbooks.

In "Dream of Red Mansions", it is described like this, two bends seem to be frowning but not frowning, and a pair of eyes seem to be happy but not happy.

can write tuberculosis into a romantic beauty, worthy of a classical masterpiece.

The Romantic poet Byron once said to his biographer, Thomas Moore, "I would rather die of tuberculosis...... For then the ladies would say, "Look, poor Byron, but how remarkable his death was!"

Because of tuberculosis, the skin is pale and the cheeks are slightly red. Because pale skin is used as a base color, the blush is more visible.

But the little girl in front of her has no such physical characteristics at all.

Further down the ...... No, the trachea seems to be offset.

Director Liang was also unsure whether he really saw the trachea shift or because of his subjective feelings after watching the CT film of his lungs. Or maybe Mr. Wu just said that there is a trachea deviation, and he feels that there is a problem.

After looking up and down for a full 3 minutes, Director Liang made the inspection to the extreme. The young woman who watched was a little scared, if it weren't for Director Liang's very kind look, the door of the clinic was open, and there were people outside, she would have fled in fear.

The doctor looked himself up and down, was he a pervert, he looked very old, his face was kind, and he didn't think he was too colorful.

After Director Liang's inspection, only the suspected left deviation of the trachea could prove that it was tuberculosis. But in general, who would go to the trachea for patients with stomach pain?

"Little girl, have you been having trouble breathing lately?" Director Liang asked softly as he looked back at the film on the reader.

"No ......" The young female patient finally breathed a sigh of relief when she saw that Director Liang was no longer staring at her, "Director, I'm fine." ”

"You wait a minute, I'll ask you a few questions. Director Liang frowned and looked at the film, "Fever, I asked you this question, right?" ”

"Yes, I haven't had a fever lately. The young woman said with certainty.

"Do you take a nap? Do you sweat a lot after taking a nap every day?"

Director Liang asked about night sweats.

Night sweats is a symptom of traditional Chinese medicine, which is characterized by abnormal sweating after falling asleep and stopping after waking up.

"Thief" has the meaning of stealing, and ancient physicians used thieves to sneak around at night every day to describe the disease, that is, whenever people fall asleep, or just close their eyes and are about to fall asleep, sweat leaks out like thieves.

Most people with tuberculosis have night sweats in the afternoon.

The young woman shook her head, affirmatively denying it.

Director Liang was very depressed, there was no difficulty breathing, no night sweats, no fever, and only cough after pain.

The last positive sign is also a normal physiological reflex of inflammation in the gallbladder area involving the diaphragm and pleura.

Even if Mr. Wu has explained the situation, let the patient do a lung CT and determine that there is a high probability that a large pleural effusion is caused by tuberculosis. However, Director Liang looked back and thought that if he treated a similar patient again, there would be no good way except for large-scale lung CT screening.

Could it be that this is the terrifying strength of Mr. Wu, who wrote the textbook "Diagnostics"?