"Doctor Karl, that's a shame. Zheng Kaixuan said, "I still want to learn interventional surgery with you, but I didn't expect you to go to Canada." However, I think this news may be pleasing to the people, after all, the Montreal Neurology Institute has determined that it is not a malignant tumor. ”

"Hopefully. Symbian Carr shrugged his shoulders and said, "It's not a malignant tumor, but it's not diabetes either, my blood sugar is fine, it's not at all." ”

As he was talking, the door of the ward was pushed open, and Wu Mian and Chu Zhixi walked in.

"Carl, I have good news for you. Wu Mian said with a smile.

"Huh?"

"Your glycosylated hemoglobin A1c level, the result is 14.7%. The normal range of the machine we measured is 4.3%~6%, which means that your glycosylated hemoglobin level is high. Wu Mian said, handing the test sheet to Saipan Carr.

"Wu. Saipan Carr glanced at the data on the test sheet and said, "Montreal, Canada......"

"Neurology research centers? They don't have a doctor who can see patients. Wu Mian said with certainty.

"......" Saipan Carr and Zheng Kaixuan were stunned.

No one expected Wu Mian to give such a sentence directly.

To say that a doctor will not see a doctor is the most serious, even harsh, statement.

"Didn't see the patient, and Carl, I guess your history of Montreal isn't complete, is it? Wu Mian asked with a smile.

"Uh......" Saipan Carr looked at Wu Mian, is the medical history so serious?

"Recently, you don't know that you have been tired and eating more than before, so you can diagnose it?" Wu Mian said.

"Wu, I think I'm tired from flying back and forth across the ocean. Saipan Carr explained.

"Carl, are they saying it could be some rare genetic system defect?" Wu Mian asked.

Saiban Carr looked at Wu Mian in a daze, at this moment he felt that he was being watched, otherwise why would Wu say what he had just said so accurately.

"Believe me, just the most common diabetes, and you didn't notice. Wu Mian said gently, "Lie down, I'll make you a waist pierc." ”

"Why?"

"Carl, if it's diabetes, the glucose monitoring in the cerebrospinal fluid doubles after hormone pulse therapy. Wu Mian said, "Make a waist wear, the answer comes out, if you still want to go to Canada, I won't stop you." ”

Saipan Carr looked at Wu Mian deeply, and only nodded after a few seconds, lying on the hospital bed, facing Wu Mian sideways.

"Teacher Wu, what can I do to help?" asked Zheng Kaixuan.

"Just look at it. Wu Mian said, "Doctors, should always take a careful medical history and physical examination to guide the initial assessment. First of all, it is necessary to rule out common causes, and we should not think of some rare causes due to reflexivity and keep grasping them. ”

Wouldn't it be better to give a diagnosis of a rare disease at the first time? Zheng Kaixuan thought to himself.

"It's called a common disease because the vast majority of patients we meet have this condition. It's not easy to be optimistic about common diseases, I've always thought so. Wu Mian said as he put on Sturley's gloves and began to make a waist shirt for Saipan Carr.

"Wu, I did an MRI to show bilateral asymmetrical enhancement of the head, which can't be explained by diabetes. Saipan Carr said sideways.

"There is an explanation for this result, and I prefer it to be a meaningless imaging finding. ”

"......" Saipan Karl was speechless.

"Carl, think of the good in everything. Lateral ventricular cysts, hydrocephalus, and intracranial space-occupying lesions have been ruled out. I watched the film for a long time, and the final conclusion was that the image performance was meaningless. ”

Zheng Kaixuan sighed slightly, Teacher Wu really dared to say it. If you go out of the clinic and say this to the patient, are you afraid that you will be scolded to death by the patient?

Patients don't care what is meaningful or meaningless, if they are like this with the patient's family, there is a high probability that they will usher in a sentence - it's useless to give me any tests, you quack.

After the lumbar puncture was completed, Wu Mian left the ward with the specimen extracted by the puncture, leaving Saiban Carr and Zheng Kaixuan, the "partners" who had not done a single operation, staring at each other with wide eyes.

Zheng Kaixuan silently looked at Saipan Carr, who was once a legendary-level doctor in his cognition now looks so helpless. Not only him, but even the doctors in Montreal were called "not able to see patients" by Mr. Wu.

Accustomed to Wang Qingshan's way of speaking abroad, and when he came into contact with Wu Mian's thinking, Zheng Kaixuan felt a little confused.

He wanted to comfort Dr. Carl with something, but Zheng Kaixuan was not good at words and didn't know what to say.

"Zheng, do you believe Dr. Wu?" asked Saipan Carr after a long time.

The voice was slightly hoarse, and Zheng Kaixuan even had the illusion that Symbian Carr's vocal cords were paralyzed.

"Dr. Karl, I believe in Mr. Wu. Zheng Kaixuan thought for a while and said very seriously, "In our country, the "Diagnostics" that medical students want to learn is compiled by Mr. Wu. ”

"But he thought I was just diabetic. "While I wish I was just a series of physiological changes caused by an increase in blood sugar, it's just a good wish." ”

"Dr. Carr, Mr. Wu has ruled out changes in nerve nodular changes and other diseases, I think you should wait for the results of the laboratory tests. Zheng Kaixuan said, "Teacher Wu is right, to judge a symptom, we have to start with the basic disease. And those rare diseases are called rare diseases because they are really rare. ”

Saipan Carr listened to Zheng Kaixuan's speech in English with an Australian accent like RAP, and even though his heart was heavy, he smiled a little.

Perhaps, I hope Wu is right.

At least until now, I haven't heard of him failing in any field.

"Zheng, when did you get here?" said Saipan Carr and Zheng Kaixuan began to chat.

The wait was so hard, and only a chat could make Saipan Carr forget that he was "seriously ill".

Soon, the door was pushed open, and Wu Mian appeared in front of Saipan Carr with a smile on his face.

"Carl, a good news or a bad news, which do you want to hear first?" Wu Mian asked.

"Good news. Saipan Carr said without hesitation.

"The content of glucosacrose in the cerebrospinal fluid of lumbar puncture was significantly increased after empiric glucocorticoid pulse therapy, reaching 22.64 mmol/L. Wu Mian said, "Coupled with the previous blood test, glycosylated hemoglobin was elevated, considering that your condition was caused by microvascular ischemia caused by undiagnosed diabetes, the asymmetric enhancement on MRI was an incidental finding." ”

"And what about the bad news?" asked Saipan Carr, who didn't have time to be happy.

"If you have diabetes, you're probably going to have to use insulin to maintain your blood sugar in the future. ”