Chapter 140 Damn it, you pretend to be B and still run away! (Please subscribe!)
Luo Yun looked at Zhou Cheng, who turned to explain to Zhang Zhengquan.
The eyes on Zhang Zhengquan's big black face opened forcefully, revealing an extremely complicated expression.
Zhou Chengcheng said: "Hysterical pain can actually be divided into two points. Hysteria is the main disease name, and pain is one of the manifestations of hysteria."
"Hysteria can also be called dissociative conversion disorder. It is a mental disorder caused by psychological factors acting on susceptible individuals. It is a mental illness."
"In addition to pain, its manifestations can also include twitching, cramps, sudden body paralysis, inability to move, or memory loss. It can also manifest as loud shouting, moodiness, difficulty breathing, blindness, etc..."
"Of course, other manifestations are not reflected in this patient. Let's talk about this patient first -"
"Hysterical pain is generally migratory."
"The pain symptoms of this patient are completely different from the pain caused by organic injury."
"Her pain is that she feels it, but she can also quickly stop feeling it. This is one of its characteristics."
"The simplest way to diagnose is to guide the patient a little deliberately to see if her pain can suddenly shift."
"Just like Teacher Luo just took advantage of his unpreparedness and suddenly disrupted the patient's train of thought!"
"She felt that the pain in her hand should be on the left side, and she also thought that the pain in her hand was on the left side, but in fact."
"We have all seen that when the patient first came in, the pain area the patient complained to us was actually on the right side..."
Zhou Cheng said so much to make Zhang Zhengquan understand him easily.
Zhang Zhengquan had a good relationship with him and helped him a lot. Zhou Cheng had long wanted to take him with him.
Luo Yun had already seen through the case just now, and so had Zhou Cheng, but Zhang Zhengquan didn't understand it at all, so Zhou Cheng could only break the disease into pieces and feed it to him, which could be regarded as reciprocating the favor.
So he continued to organize the language and continued:
"If there is metastatic pain, you should go to neurology or psychiatry for treatment. Our orthopedics department cannot cure this kind of thing."
"Hysterical pain often occurs after traumatic stress. But in most cases, the patient and his family can be sure that the patient has not suffered any trauma or surgery or other directional stress."
"However, stress is not called direct traumatic stress."
"In some special circumstances, situations that may be contrary to our values may also arise."
"For example, if there is a traffic accident and you are the victim and you have to pay more, you may pretend that there are no symptoms at first, but the more you pretend, the symptoms will actually appear. The patient is also really in pain!"
"The other type is reward addiction! For example, if a person shows pain and attracts more attention or pampering than usual, which she really wants, it will also appear."
"So, most of the patients we often see are adolescent girls. Maybe menopausal women are also more sensitive and there will be relatively more..."
Zhou Cheng talks eloquently and explains the profound things in simple terms.
Even Zhang Zhengquan nodded frequently.
The shock and astonishment at the beginning gradually turned into a sudden realization.
Zhou Cheng really explained the disease in detail. Although he did not summarize it, he explained everything from the pathogenesis to the reasons why it is more common in which group of people. It was not boring. Zhang Zhengquan really understood it.
"There is such a disease, I have never heard of it." Zhang Zhengquan was very surprised and bowed slightly to express his admiration and gratitude to Zhou Cheng.
Luo Yun just smiled and said, "Call the next patient to come in."
I felt quite helpless in my heart. Although I was surprised by Zhou Cheng's extensive knowledge, I didn't say much.
In fact, this disease is not a disease of joint surgery, but belongs to the psychiatric department. Luo Yun also encountered it several times in the joint department before he understood it. This is nothing. In the psychiatric department, this disease is also common.
series.
Zhou Cheng reads a lot, so it's okay if he realizes it.
Next time, I must look for a very professional disease treatment.
Zhou Chengzhun was about to raise his steps, but Zhang Zhengquan immediately said: "Brother Zhou Cheng, I'll shout."
Zhang Zhengquan knew in his heart that the purpose of his coming here today was just to earn a living. There were so many outpatients that he definitely didn't have time to do teaching rounds. Zhou Cheng was willing to say that he could learn something now.
The time in the outpatient clinic is squeezed in, and there is no time to waste.
The second patient came in soon.
She is an elderly woman with obvious deformity of her right lower limb. She is short, obese, with dark complexion and half-white hair that is not well taken care of.
She limped in, and the person supporting her was a woman in her thirties. She said, "Mom, walk slowly, and be careful not to trip over your legs."
After coming in, Zhou Chengcheng quickly noticed that her right lower limb was obviously inverted and her lower limbs were obviously unbalanced.
The left leg is much longer than the right leg. When walking, after the left foot touches the ground, the right side of the body swings.
When his right leg landed on the ground, he frowned and gritted his teeth. It seemed that every step he took was completely painful!
"Ao'an, please sit down first. How many years have you had pain in your leg?" Zhang Zhengquan immediately asked the patient to sit down.
The middle-aged woman next to her replied: "My mother has been in pain for more than ten years. It hurts when it rains, it hurts when walking, and now it hurts even when sleeping. I was treated in the county hospital and took medicine and it healed for a while.
Now the pain is excruciating again.”
"Have you ever taken any pictures at the county hospital?" Zhang Zhengquan asked, looking at the plastic bag in her hand, which clearly said C County People's Hospital.
"Yes, there are, but they have been there for several months. Do you want to see them? Do you want to take a new one?" The woman said while taking out a lot of films inside: "When I went to the county hospital in the past, the doctor
It’s useless to talk about previous films.”
"So I take pictures every time I check again. I have a lot of pictures here."
“I still have the ones from ten years ago to now.”
When Luo Yun heard this, he immediately became energetic and said quickly: "It's useful. These films are the most useful!"
Just kidding, these X-rays simply objectively record the development and course of the patient's condition, how could they be useless?
Neither patients nor their families can tell their medical history in such detail and objectively. This complete set of X-rays can be said to truly record the development and evolution of a disease.
There are many films, and they are arranged very neatly. They are all arranged in chronological order. In addition to X-rays, there are also CT and MRI, but both CT and MRI are of the lumbar spine!
It can be seen that either this old woman is a very particular person, or the middle-aged woman next to her, who is not sure whether she is her daughter-in-law or her daughter, takes good care of herself.
Because there are so many movies, everyone in Zhou Cheng’s group has a movie to watch!
Let’s look at the most recent films first. The plain films taken a few months ago may be different from the current condition due to the time gap, but the content in the films is only slightly different.
The one Zhou Cheng is holding is from one year ago, the one that Luo Yun is holding is the most recent one, and the one that Zhang Zhengquan is holding is from nine months ago.
When Zhou Cheng read the X-ray, he discovered very obvious knee osteoarthritis!
Knee varus deformity.
Luo Yun, on the other hand, after flipping through several films one by one, his heart moved again!
Good guy, this movie is interesting again, so he looked at Zhang Zhengquan and asked: "Zhengquan, did you see anything?"
Zhang Zhengquan's face immediately froze when he heard this, his eyes continued to open a little wider, and after looking more carefully, he turned around and replied: "This is knee arthritis!"
When Luo Yun heard this, he rolled his eyes.
Ah tui!
What the hell?
Are you embarrassed to say such an extremely unprofessional diagnosis as arthritis?
Arthritis is also divided into many categories, including osteoarthritis, septic arthritis, tuberculous arthritis, gouty arthritis...
However, considering that Zhang Zhengquan was not a joint surgeon, Luo Yun did not complain about him.
Before Luo Yun turned to look at Zhou Cheng, Zhou Cheng asked the middle-aged woman: "Has your mother ever had a fracture before?"
Upon hearing this, Zhang Zhengquan immediately turned to look at Zhou Cheng.
Ever had a broken bone?
How did you get it?
Brother Zhou Cheng, are you a doctor or a fortune teller?
This is not easy to say nonsense!
When Luo Yun heard this, his expression flashed.
In addition to the types of inflammation, the causes of arthritis can also be divided.
This patient indeed has classic osteoarthritis.
The two classic manifestations of osteoarthritis are joint space narrowing and articular cartilage wear and tear. This is written in the definition, and it is also very obvious to read when reading the film.
but?
The diagnosis of traumatic arthritis is a causative diagnosis. Generally, this diagnosis can be made routinely by asking the medical history to complete the diagnosis.
Because you don’t even ask, how do you know if it’s trauma?
Traumatic arthritis…
Of course, the traumatic experience of traumatic arthritis will be permanently written on a person's body, and it requires highly advanced film-reading skills to be able to see that the patient has had fractures or injuries in the past.
This is a very professional reading technique.
Originally, Luo Yun was planning to leave this X-ray to Zhou Cheng and Zhang Zhengquan to teach a lesson, but he didn't expect that Zhou Cheng would tell the truth right after they started!
Zhang Zhengquan quickly asked the middle-aged woman: "Has she had any fractures before?"
"No? My mother-in-law has never been hospitalized or injured?"
The middle-aged woman hesitated for a moment and was very sure.
Then he turned around and asked again in the local dialect: "Mom, have you ever had a fracture before? The doctor is asking you."
Then he said with some embarrassment: "Doctor, this is my mother-in-law. She has been in good health since I got married, but her legs are not that good and she has not had any surgery."
The patient understood what his wife said, raised his head and said, "Is the bone broken?"
"I have broken bones before. It was when I was very young, in my teens. I was still a girl."
"At that time, I was working in my hometown and fell. Later, my fracture was cured by the doctor in the village."
"Doctor, how do you know my bone is broken?"
"I personally almost forgot about it."
"You are really amazing." Luo Yun and others could understand 70% to 80% of what the patient said.
The patient immediately held Zhang Zhengquan's hand and squeezed it so excitedly that it even hurt.
When Zhang Zhengquan heard this, he was like, oh my god (‵o′)!
It’s really a broken bone!
"It's what you see in the movie." Zhang Zhengquan could only reply.
But when he went back to read the film seriously, he was like, Damn!
The movie didn’t mention traumatic arthritis!
Is a deformed joint a sign of traumatic arthritis?
What's going on?
Luo Yun said: "You are her daughter-in-law, right?"
"Yeah!" The middle-aged woman nodded.
"Her current condition is very serious. She can no longer walk. As you just saw, every step she takes is a step of suffering."
"To be honest, I admire her that she can still walk in her current condition. Your mother-in-law can endure the pain very well." Luo Yun sighed with emotion.
The middle-aged woman nodded and said: "My mother-in-law is a very hard-working person. My husband and I wanted to take her for surgery ten years ago, but at that time my mother-in-law was reluctant to give up the money and thought she could still go. Moreover, the doctor at that time
He said she was not old enough, so he said she would have surgery in a few years."
"But recently when I took my mother-in-law to see a doctor, she still refused to do it, so I had no choice but to take her here." The middle-aged woman said helplessly.
When Luo Yun heard this, he nodded and said: "Well, I might have been a little younger before. If I had had the surgery at that time, I would definitely have had another surgery, so how many years can it be delayed?"
"I can still keep walking now, which proves that my muscles have not atrophied."
"But I have to undergo surgery to get well again." Luo Yun said directly.
This is an interesting case. The joint deformation is so severe. How to restore the alignment, how to make up for the shortened length of the affected limb, and straighten the re-deformed joint...
It's still a little challenging.
Luo Yun was quite looking forward to it. His hands were so busy that his balls ached. If such a complicated primary joint replacement could be the first joint replacement surgery he performed in the department.
It was really comfortable, a feeling like meeting old friends again...
"Are we going to have surgery?" Lao Ao was so frightened that she stood up, not caring about the pain in her legs.
But she immediately asked the key question: "So? How much will it cost?"
Just when Lao Ao asked, the middle-aged woman next to her said, "Mom, please sit down first. This surgery is not expensive. The doctor told me that it is not expensive."
Then he turned to look at Luo Yun, lowered his voice and said, "Doctor, don't talk to my mother about money."
"She can't part with money," the middle-aged woman said.
"At least 30,000 to 40,000 yuan should be prepared. She is going to have a joint replacement, and the joint prosthesis will cost at least 20,000 yuan. This will not be reimbursed." Luo Yun said expressionlessly.
It’s not necessarily a question of who doesn’t want to part with money.
"doctor."
"Can our county hospital perform this surgery? Is it cheaper?" the middle-aged woman asked.
She remembered that when she was in the county hospital, the director also told her that she needed to have a joint replacement, but that she had to hire an expert to do it. The money for the expert was not reimbursed and she had to pay for it herself. Otherwise, they would go to Shashi for treatment.
, eliminating the expense of hiring an expert.
Luo Yun replied with some embarrassment: "I don't know whether doctors in other hospitals can do it. I haven't seen it, so I can't comment. It may or may not be possible, and I don't know about the cost.
Already."
"If it were on our side, the savings would be at least over 30,000 yuan."
"Zhou Cheng, please write down that it is recommended to undergo joint replacement surgery. Otherwise, there will be risks such as paralysis and muscle atrophy."
After Luo Yun said this, he added: "In her current condition, taking medicine will definitely not work. You see."
"On the plain radiograph, her joints have completely collapsed, without any joint space, and the bones are grinding against the bones. No matter how much painkillers are taken, it can't stop it. Taking painkillers will only cause more damage to her stomach.
.It’s also a waste of money.”
"Her current symptoms are that she can no longer walk. As I said just now, every step she takes is a torment for her."
The middle-aged woman's expression immediately changed, paralyzed?
He quickly asked: "How long will it take for my mother-in-law to become paralyzed if she doesn't undergo surgery?"
"I can't judge this. If she stays still after she goes back, she may still be in this situation. But if she doesn't move, it won't be much different from paralysis." Luo Yun can't guarantee it. Who can say this?
Accurate?
"After the operation, will she be able to walk? Will she need to use a wheelchair or crutches?" She then asked.
"Then if she has to use crutches or sit in a wheelchair after the operation, I will definitely not do it for her." Luo Yun was very angry.
"Nowadays, paralyzed people can still move in electric wheelchairs. The money for surgery can be enough to buy several wheelchairs."
"In her current situation, the prognosis of the operation may not be very good, but as long as she recovers well and exercises well after the operation, there will be no difference between her walking posture and that of the old ladies outside." Luo Yun replied confidently.
road.
"With my grandson, simple housework such as cooking, shopping for groceries, and doing laundry will definitely not be a problem."
Luo Yunyi said pointedly.
The middle-aged woman's eyes suddenly lit up after hearing this: "Thank you, doctor, I'll think about it!"
After saying that, she opened the address book on her phone as if she was preparing to call someone.
But after hesitating for a moment, he said directly: "Oh no, doctor, just give me a hospitalization certificate. I will take my mother-in-law to the hospital and perform the operation on her."
Luo Yun pursed his lips to signal to Zhou Cheng. Zhou Cheng hurriedly went to write the hospitalization certificate and gave Luo Yun a thumbs up in a daze.
Luo Yun then said to the middle-aged woman: "You have to think carefully and discuss it with your family. Surgery for the elderly still carries certain risks and costs a lot."
"It's not as simple as going to the market to buy groceries." Although Luo Yun wanted to perform the first joint replacement surgery in the department, he would not do surgery just for the sake of surgery.
"Well, okay. Dr. Luo, I will discuss it with my family." The middle-aged woman said seriously.
Luo Yun just said a reason why she couldn't refuse.
My mother-in-law, after the operation, can walk well and can do laundry, cooking and buying groceries. For her, this is a big liberation. She can also go to work and have someone to pick up and drop off her baby.
Kill several birds with one stone.
"Then you can make an appointment in the second ward of the Department of Orthopedics later. You should be admitted to the hospital soon!" Luo Yun said, looking at the old woman and sighing.
When a person is old, he has spent his whole life working for his son, buying a house and a car. In the end, if he has no money, he will not have much say in treating himself.
This is a living fact.
However, this daughter-in-law can be regarded as relatively filial. Although the reason she gave was just right and it hit the spot in her heart, she agreed to have the surgery without hesitation.
But, it's thoughtful enough.
It's not in vain that I put in some effort.
The old man is pitiful, and his wife's clothes don't look like someone who is short of money.
"Mom, let's go first and make an appointment in the ward. Your legs are useless after taking medicine." The middle-aged woman explained seriously.
"Are you going to be hospitalized for surgery?"
"That would cost a lot of money, so I won't do it. It's too expensive, so I won't do it!" What Luo Yun didn't expect was that the old man shook his head resolutely and stingily, and even fled the clinic tremblingly.
"We will figure it out for our children and grandchildren when it comes to money. Don't worry. Your good health is the most important thing."
"We planned to let you do it a few years ago. You said it would cost money. At that time, we had just bought a house and we really didn't have that much money. The money was valuable at that time, but now, your grandchildren's annual tuition will be a lot.
several thousand."
"They also want to take you to the amusement park to play together. It won't cost much."
"Even if you feel sorry for the money, just treat it as money to spend more time with Zhouzhou and Lanlanhua. Is that okay?" the middle-aged woman comforted her mother-in-law...
Only then did the old man become interested.
"How much does it cost?" the old man raised his head and asked.
"It's not expensive, only more than 10,000!" After saying that, he winked at Luo Yun.
It seems that she hopes Luo Yun will help her keep it a secret and not expose it.
The old man lowered his head and murmured: "More than 10,000, more than 10,000. At that time, more than 10,000 was enough to buy several big houses. I only earned so much money in my life..."
"Mom, it was when you were feeling strong that your legs were weak. Money is worthless now." As she said this, she took the hospitalization certificate and prepared to help her mother-in-law to the inpatient department.
Luo Yun hurriedly suggested: "Sister, help your mother-in-law out and sit down first, and then go down and rent a wheelchair and push your mother-in-law to the inpatient department. It really hurts for her to walk now."
The middle-aged woman's eyes immediately lit up and she said, "Okay, thank you doctor, you are such a good doctor."
After saying that, she turned around and helped her mother-in-law out of the consulting room.
Luo Yun looked at the backs of the two of them and muttered in his heart, it seemed that he had seen the wrong person!
It turns out that the person who has been unwilling to undergo surgery is not the daughter-in-law, but the elderly who are reluctant to part with money.
…
After he walked out, Luo Yun looked at Zhou Cheng again, his mind racing.
It's surprising that Zhou Cheng could actually see this traumatic arthritis. This is quite professional joint surgery knowledge.
It seemed like Zhou Cheng had tricked him again.
However, after being admitted to the hospital, Zhou Cheng will be able to see you.
Diagnosis and treatment are two different things.
However, could it be that Zhou Cheng didn't work hard enough to understand the difficulty of this operation?
Luo Yun's mind was elsewhere.
Zhou Cheng was also looking at Luo Yun, his heart fluctuating——
Teacher Luo must be too good. After the first patient came in, he explained it clearly in a few words. Now it takes only a few words to get the patient's family to agree to the operation.
Zhou Cheng also knows that the patient must undergo surgery, but the doctor only has the right to make suggestions on how to persuade the patient to go in the most beneficial direction.
This cannot be explained clearly in one or two sentences.
This is trying to figure out people’s hearts!
Taking care of grandchildren, cooking and washing clothes...
Are these things related to the medical profession? They have nothing to do with it at all. They do not reflect a person's medical professionalism at all.
but?
Just these few words made the patient's daughter-in-law's heart beat.
Before he could speak, Zhang Zhengquan asked Zhou Cheng: "Brother Zhou Cheng, how did you just see that the patient had a fracture? Can you tell?"
Zhou Cheng turned back to Zhang Zhengquan and said: "Quanzi, the imaging of the X-ray film is actually whether the X-ray can hit the opposite side to form a dark shadow. In this process, the less tissue passes through and the sparser the density, the
Then the more shadows you can hit."
"Our bones have a trabecular structure. The trabecular structure is very special. It is arranged very neatly when we are born."
"Please understand that the trabecular bone structure is hollow and will form a very smooth and complete line-like structure on the X-ray film, right?"
Zhang Zhengquan nodded thoughtfully.
"Yes, the trabecular bone structure is complete and continuous at the unfractured bone end. But after the fracture, even if it is fully recovered, the trabecular bone structure will be disrupted and reorganized. At this time, let's look at the previous lines
structure."
"You'll find there's a crossover."
"This is the sign of past fractures and traumatic arthritis. This is the information that will be shown to us on the plain radiograph!"
"It's a pity that the film was taken away by the patient, otherwise."
Zhang Zhengquan immediately said: "Brother Zhou Cheng, I'm going to get it, but the patient is still waiting at the door..."
After Zhang Zhengquan finished speaking, he left the clinic, then went to the door of the clinic and took a few deep breaths.
I feel a little astringent in my heart——
Damn, it’s really hard in this world right now, and it’s really hard to make a living.
Zhang Zhengquan almost broke his heart with a bitter smile secretly. Why should I come to Luo Yun Clinic to get a meal?
This isn't just for fun, it's just for abuse...
Luo Yun understood it, Zhou Cheng also understood it, but he didn't understand it. Two patients in a row were as if they were listening to a book from heaven.
Alas, I don't blame Luo Yun and Zhou Cheng. They came to the outpatient clinic in good manners. It was obvious that they insisted on coming here to get food. Maybe they considered their own food and didn't ask for it.
I?
It's so hard for me...
After Zhang Zhengquan walked out, Luo Yun sat down, glanced at Zhou Cheng, and said casually: "Xiao Zhou, you have read a lot of books. The review of traumatic arthritis is also from the video
of?"
Zhou Cheng turned his head and looked at Luo Yun in shock. He really didn't expect Luo Yun to ask this suddenly.
Nodding awkwardly and hahaha: "Ang, ang, ang..."
I secretly apologized to Luo Yun——
Teacher Luo, I'm sorry, actually I licked these, and I even licked you to death.
I will remember you well.
Luo Yun: "..."
The corners of his eyes twitched, feeling that Zhou Cheng was quite disgusting.
Watch videos to learn medical skills?
Nonsense.
But no flaw was found.
He was tricked...
…
The third person Zhang Zhengquan introduced was a young man, aged 27 or 28, wearing glasses with black eye sockets.
He is of medium build and looks polite. He should be a clerk in an office or engaged in writing work.
However, he walks neatly on his feet and swings his hands normally.
He was holding a small document bag in his left hand.
He doesn't look like a sick person.
Zhou Cheng also glanced outside the door, wondering if Zhang Zhengquan had closed the door too quickly, blocking the real patient out.
Zhang Zhengquan still asked politely: "Hello, what makes you uncomfortable?"
With a smile on his face, the young man glanced at the three people in the consulting room and saw Luo Yun, the oldest, passing by Zhang Zhengquan and Zhou Cheng.
Address Luo Yun directly: "Hello, doctor."
"I came to you to buy two kinds of medicine. I went to many pharmacies but couldn't buy them. I asked a friend to find out and they said that the Eighth Hospital has them. I work in the park and I don't have time to come here on weekdays. I'm still working overtime today.
This is because I asked for leave."
The park is the abbreviation of Xing District Industrial Park.
As he spoke, he took out a piece of A4 paper with the name of the medicine on it from the document bag.
The words are handwritten and quite neat.
It clearly says:
Sodium hyaluronate injection (Spite).
Hydrocortisone acetate (SINE).
Even the name of the company that carries the medicine is written down, which is really detailed!
Seeing these two drugs, Zhou Cheng was slightly startled.
Sodium hyaluronate injection is a lubricant injected into the joint cavity. Generally, it can only relieve the symptoms of osteoarthritis patients in the early stage of osteoarthritis.
But if it is used for a long time, it is of no use at all.
Even if it is written in the guide, it is irrelevant. (PS: Here, I would like to warn my book friends, if you go to an orthopedic clinic, never do this thing. It is of no use.)
Hydrocortisone is a glucocorticoid. A small amount taken orally can have an analgesic effect, but if taken for a long time, the sequelae will be unimaginable.
First there is gastric damage, then there are changes in systemic immunity, and then there are various complications of glucocorticoids. Buffalo back, moon face, etc...
Who prescribed these two medicines?
Before Zhou Cheng could say anything, Luo Yun asked, "Why do you want these two drugs? Has your mother been taking them? How long have you been taking them orally?"
The young man smiled reluctantly and asked: "Doctor, this doesn't matter. I'm not here to see a doctor today. I'm just here to prescribe a medicine. After you finish prescribing, I'll leave."
I thought, why are you asking me so much when I have money for you?
However, he patiently explained: "I asked a lot of friends and checked professional guides online. Both of these drugs can treat arthritis. And after my mother took it, her legs and feet became much better."
.”
Okay!
Nowadays, with the improvement of people's knowledge, simple Baidu medical consultation can no longer satisfy you?
Have you started using the guide to see a doctor?
Zhou Cheng and Zhang Zhengquan were both quite nervous and didn't know how to deal with it, so they only looked at Luo Yun.
The two of them didn't dare to talk about the guide.
Luo Yun frowned and said:
"Well, you are right. Sodium hyaluronate can indeed prevent the progression of osteoarthritis in the early stages. This is also written in the guide book."
"But it's also prevention, just in the early stages."
"Hydrocortisone has also been used clinically for a period of time. It can be found not only on CNKI but also on Pubmed." Luo Yun said angrily.
"But do you know what the side effects of these two drugs are?"
"Why can't they be used for a long time?" Luo Yun asked back.
The young man frowned again: "I know, it seems to be some kind of glucocorticoid, which can fight inflammation and allergies."
"Doctor, please don't ask so many questions. These two drugs were prescribed to my mother by experts in our county hospital, and she has been using them. Can that expert still harm her?" He also looked at his watch.
on time.
"I came here on leave. I really don't have much time. If I arrive late, my money will be deducted."
"If it weren't for the fact that I couldn't buy it in the pharmacy, I wouldn't bother you here. Please do me a favor. After I get the medicine, I have to send it back to my mother. Save me some time."
Luo Yun pushed back the young man's medical card.
Although he also knew that this young man might have to work on weekends, and it was not easy to work nine to five.
However, the first principle of a doctor is to do no harm!
Apologizing with all his face, he said: "Sorry, I'm sorry, although we have these two medicines here, I can't prescribe them to you!"
"If you are here to see a doctor, I can show you slowly and you can tell me where you feel uncomfortable."
"Why don't you prescribe it? Is there something wrong with you?" The young man's voice suddenly became louder. He was joking, I came here on leave, you have medicine here and you won't sell it to me? You think I have no temper, right?
"I just asked you to prescribe medicine. You are a doctor. Isn't your job just to see patients and prescribe medicine? Why don't you prescribe it to me?"
Luo Yun was not afraid of the stage, and explained: "First of all, I am a doctor, and treating patients and prescribing medicine is one of my responsibilities."
"But, you also said, it is to see a doctor and prescribe medicine, not just to prescribe medicine. I have to see a doctor first."
Then Luo Yun explained to him: "You registered my number, and my name is yours, yes. I have a medical relationship with you, and we only have a medical relationship in this clinic. When we go outside the hospital, I will treat you.
It’s illegal.”
"This is the first point."
"Second, if you register with me, I will only be responsible for treating you. Real-name medical treatment is required by law. This is also stipulated by law. It is also illegal for me to treat anyone other than the registered person."
"Third, the reason why hospitals exist is because the medical relationship must be close, and the diagnosis and treatment relationship takes place in the same space."
"Although cloud diagnosis and treatment is currently developing, I have not yet opened an online clinic, so I do not provide cloud diagnosis services."
"You should know about cloud diagnosis and treatment, right? I don't have the authority to conduct cloud diagnosis and treatment. This is also against the regulations."
"Fourth, based on the principle of do no harm."
"The drugs on your prescription are all prescription drugs, although I don't know who prescribed them to you."
"But it doesn't get my approval! I also have the right to prescribe it myself. So, I don't think you need to use these two drugs at all, so I can't prescribe them to you."
"Fifth, if you don't feel any discomfort, just cancel this number. I can't provide you with medical services, and I'm embarrassed to ask for your registration fee."
Luo Yun counted them one by one without getting angry.
The young man immediately became angry: "You can't take this kind of medicine, and you can't prescribe that kind of medicine."
"Then when I took my mother to see a doctor, your doctor used other drugs to cure her? Aren't these drugs prescribed by your doctor? You co-authored it to trick me!"
"Are you saying you need surgery? Do you have any medical ethics? Are you just trying to make dirty money?"
"If I ask you to prescribe a medicine, will it harm your interests? I won't make you enough? Why won't you prescribe it?"
"Do you believe I reported you?"
At this point, he became angry. He had at least a dozen pharmacies.
I was stunned but couldn't find it. I finally found out about the existence of this kind of medicine and was told that I could only give it to him if I had a prescription.
He registered, but Luo Yun still refused to open an appointment. Today, the orthopedics department is the only outpatient clinic.
Besides Luo Yun, who should he go to?
Luo Yun took out his cell phone without fear, pressed the record button first, and said, "Put your cell phone away first. Photography and recording are not allowed in the clinic."
"You can report me! As long as you can find the reason and logic for reporting."
"This is your freedom, but I have not infringed or harmed you, so you are not qualified to infringe on my right to image."
"Otherwise, I will reserve the right to pursue your legal responsibility at all costs."
"I'll say it again, I am a doctor at Shashi No. 8 Hospital. This is a hospital, not a pharmacy. There is only a diagnosis and treatment relationship in the hospital, and there is no commercial consumer relationship between consumers and merchants."
"I don't see the patient, I can't see the doctor, I can't diagnose, I can't treat."
"If you need medical treatment, you can tell your symptoms in person!"
"I will do my best to treat you. No one else has anything to do with it."
"Tell me, what's wrong with you?"
After saying that, Luo Yun still turned on the recording.
He said calmly: "Do you have anything else to do next? If not, please leave. You can also cancel your account. Is that okay?"
The young man caught a glimpse of Luo Yun recording and was slightly stunned. He seemed to be frightened by Luo Yun's words.
He gritted his teeth again and asked, "Are you sure you don't want to prescribe medicine for me?"
Luo Yun only said: "I'll say it again. It's not that I don't drive it, it's that I can't drive it!"
"And I'll give you a piece of advice."
"If you really believe that I am a doctor and a doctor with professional abilities, just believe me. When seeing a doctor, the patient and the doctor need to see each other face to face, instead of buying medicine, all the diagnosis and treatment relationships can be completed.
.”
"And if you believe that I am not a psychopath, I believe that our hospital will not allow a psychopath to sit in the outpatient clinic and be an outpatient doctor."
"And if you think I'm not a bitch who likes scolding."
"Just believe that if I don't prescribe medicine for you, it's not that I'm embarrassing you, but that you're embarrassing me."
The young man grabbed the list and left, because there was already a security guard lingering at the door.
But after he left the consulting room, he looked at Luo Yun hatefully.
I guess I'm still feeling very depressed.
After he left, Luo Yun sighed slightly: "Well, it's hard to say that he is filial. After all, he is not a doctor. It's hard to say that he is filial."
Zhou Cheng and Zhang Zhengquan nodded at the same time.
However, Zhou Cheng also became more respectful to Luo Yun in his heart.
What Luo Yun said just now is not something that ordinary people can say or think out. It requires a certain level of skill, and it involves skills and an understanding of medical relationships, which is also relatively thorough.
At least, Zhou Cheng had never heard anything like this from anyone else.
It seems that I can really learn a lot from Luo Yun's clinic today.
However, just as he was thinking this, a call came from Du Yanjun, saying that a patient with emergency dislocation came to the ward and asked Zhou Cheng to handle it.
Zhou Cheng apologized and explained to Luo Yun that although Luo Yun was quite reluctant in his heart, Zhou Cheng was still on duty anyway, so he couldn't keep him here any longer.
It's disgusting to leave immediately after pretending to be B...