Chapter 1709: Chapter 1713: The Eerie Key!
A charade ensued, filling the emergency department with sudden energy in the morning.
Bringing along the theories of the older folks, Chen Cang realized that no luxury item could rival even a regular ICU patient.
Casually, even a stent or a bridge costs tens of thousands.
Tsk, tsk, tsk.
Thinking about this, Chen Cang felt he gained some insights this morning.
However, later in the morning, while Chen Cang was in the office, a unique patient arrived at the emergency department.
“Professor Chen, we’ve got a rare case,” Wu Hui hurriedly came running out and said to Chen Cang.
Chen Cang was stunned, “What’s going on?”
After speaking, he followed Chen Cang outside.
“Doctor, doctor, quickly look at my hand!”
An elderly lady, around sixty, sat in the office with a pained expression. A group of doctors surrounded her, each furrowing their brows, appearing puzzled by her predicament!
Chen Cang couldn’t help but ask, “Ma’am, what’s wrong?”
Upon hearing this, the elderly lady, full of pain, extended her hand, “Doctor, look, my hand hurts so much!”
Chen Cang immediately asked, “What’s going on?”
The elderly lady pointed at Luo Zhou, saying, “He broke it!”
Luo Zhou looked helpless.
Chen Cang frowned, “What happened?”
Luo Zhou explained helplessly, “Just now, an ambulance arrived. There was a patient on a stretcher urgently sent to the emergency room. This aunt happened to be standing there, and I just pulled her aside.”
“As a result, her hand hit the door handle.”
“Director Chen… I’m sorry.” Luo Zhou genuinely didn’t want to cause trouble for Chen Cang and apologized.
The aunt quickly said, “Young man, I don’t blame you. I understand; you must be busy. Don’t worry, I’m not someone who seeks petty advantages!”
“I feel like I got pricked by a needle with a sharp stab — it really hurts.”
“I’m not worried about anything else; I’m worried about contracting some strange disease. You know, nowadays, things are complex — look, look! I saw on WeChat a few days ago that there are many bad people around! They place needles on buses or vending machines! They even put them on hospital door handles; some AIDS patients love doing this!”
The elderly lady spoke rapidly, babbling on and on!
Chen Cang was helpless; the emergency department’s door is opened and closed every day. How could there be needles placed there?
Who would have the time for that?
However, to be safe, Chen Cang still took the lady’s hand, meticulously examining her right palm, but found no needle marks or wounds.
Moreover, if pricked by a needle, there would definitely be trauma. Chen Cang even activated his gaze but didn’t see anything!
Looking at the tense Luo Zhou, Chen Cang patted his shoulder and said, “It’s okay!”
“Yali, can you take the aunt for a hand X-ray?”
“Aunt, don’t worry, we’ll give you a complimentary check-up!”
The aunt readily nodded, “Alright then, I’m not trying to take advantage or anything.”
Half an hour later, the X-ray results were out, and nothing unusual was found in the right hand!
No fractures, joint abnormalities, soft tissue issues, or foreign objects could be seen…
Could it be nerve damage?
Thinking about this, Chen Cang performed a thorough neurological examination on her.
But not a single problem was detected!
The elderly lady’s stabbing pain wasn’t radiating, didn’t spread beyond the palm, didn’t change with posture, and had no tenderness or knock-pain — not typical of nerve damage.
Chen Cang suddenly considered a possibility, could it be… extortion?
Thinking about it, Chen Cang felt it wasn’t impossible!
After all, the sudden hand pain must have a reason, right?
Chen Cang suddenly said, “Aunt, this is rather complex. We might need to perform surgery to check!”
“This could be a dangerous, complex, neural tangential stimulus pain, rare worldwide and could even require cutting the hand nerves short!”
Upon hearing this.
The elderly lady suddenly claimed the pain was gone, adamantly refusing any surgical inspection.
After speaking, she said to Chen Cang, “Are you the director?”
Chen Cang nodded, “Yes, I am.”
The elderly lady said, “Director, I’m from out of town, unfamiliar with the area, and I don’t know where to go. Besides, I’m worried my hand might suddenly hurt again. Why don’t you let me stay at the hospital for observation?”
Upon hearing this, Chen Cang felt helpless.
Did you think the hospital is a hotel, allowing anyone to stay as they please?
Everyone suddenly realized they were dealing with extortion!
Chen Cang said, “We don’t have extra beds here; they’re reserved for patients and emergencies.”
Chen Cang wanted no trouble, so he asked the nurse to quickly escort the patient away to avoid delaying other patients.
Qin Yali was quite kind, quickly pulling the aunt away, and even kindly took out her phone app to search for nearby hotels, persuading her to leave.
Initially, they thought the matter was over.
But, to everyone’s surprise, the elderly lady returned in the evening!
Everyone was ready to leave work when they saw her, and their hearts skipped a beat.
Fortunately, Qin Yali reacted quickly, promptly approaching to ask what was wrong.
The elderly lady immediately began to complain.
“Doctor, the hotels aren’t suitable; they’re unsafe. Think about it; there’s an organization called the darknet. They target people like us, abducting us for human experiments. And… imagine if they cut out my kidney?”
“What if the hotel has cameras?”
“And, some AIDS patients deliberately place needles on the bed…”
Chen Cang immediately frowned!
Here we go again!
Do you have some misunderstanding about needles?
Chang Lina just switched shifts, and hearing this, she couldn’t help herself and blurted out, “Are you sick! This is paranoia! Paranoia of persecution!”
Everyone was stunned by the words, wondering if… this aunt really has mental issues?
Chen Cang took a deep breath at this moment; his neurology diagnostic skills are top-notch!
However, he still couldn’t see anything unusual about this aunt.
Then, Chen Cang scheduled a CT and MRI scan for her head, along with some blood tests.
He also settled the aunt down and took care of the paperwork.
Importantly, the aunt was very cooperative and even voluntarily took care of the expenses.
Thus, the night passed.
During Luo Zhou’s night shift, Chen Cang told him to pay extra attention just in case this aunt might have a mental disorder.
But Chen Cang couldn’t diagnose anything yet.
Although Luo Zhou was nervous, he nodded in agreement.
The next day, the results came back, and everything was still normal!
Head CT and MRI: No significant abnormalities observed.
In the blood test, apart from slight anemia and low white blood cells, liver and kidney functions, electrolytes, thyroid function, blood sugar, blood ammonia, vitamin B1, infection indicators, HIV and syphilis were all normal.
Chen Cang even left a urine sample to test if the aunt was on drugs; results were all negative.
This aunt with abnormal behavior doesn’t seem like a neurology patient.
With this in mind, Chen Cang conducted some simple cognitive tests on her.
“Which city are you in now?”
“Northern River Province”
“What’s the capital?”
“Tianjin”
“What’s 100 minus 20 minus 20 plus 20?”
“200!”
The situation suddenly became complicated.
Chen Cang decisively performed a MoCA scale test on her, and she scored only 21.
Recalling her nonsensical speech before, it seems she truly has cognitive impairment.
Unexpectedly, the more she talked, the more excited she became, claiming she grew up in the United States with high innate talent.
She skipped grades in both elementary and high school, then became an agent for the FBI, and later joined NASA for a mysterious research project.
Now she has returned to join China’s national security department!
For the sake of “state secrets,” she has never married, has no family, and no friends.
Finally, she mentioned she once volunteered in a psychiatric hospital but was never hospitalized.
No doubt about the mental illness.
Here, Luo Zhou prepared to contact the psychiatric hospital.
But suddenly, Chen Cang hesitated, feeling something was amiss.
What was missed exactly?
At this moment, coincidentally, the psychiatric hospital called, saying that a mental illness diagnosis can’t be made casually, with the key criterion being: there must be mental symptoms present for most of the time for 1 month or longer.
But this aunt hadn’t even been here for one day yet, and no one could prove whether she has a mental disorder.
However, with organic issues ruled out, isn’t primary mental illness the only possibility left?
“Didn’t she say she used to stay in a psychiatric hospital? Maybe she escaped from there,” Luo Zhou was more convinced she had a mental disorder.
“Yes, yes, and her prolactin level was elevated in the blood test, possibly due to previous use of anti-psychotic drugs,” Chen Bingsheng said directly.
“I wonder why she’s anemic?” Chen Cang suddenly spoke.
“Anemia? That’s quite normal, right?”
“Right, mental disorders can coincide with slight anemia; psychiatric patients often have an unbalanced diet, so mild anemia is normal, isn’t it?”
As everyone was discussing and planning to send this patient away.
Chen Cang’s brain suddenly started spinning, and then a clue formed, and an information popped into his mind!
“Yes, I remember now!”
“In the textbook section on megaloblastic anemia, it mentions that vitamin B12 deficiency can cause neurological and psychiatric symptoms, such as distal limb numbness, unsteady gait, ataxia, depression, memory decline, hallucinations, delusions, and even mental confusion!”
Upon hearing this, everyone was stunned!
Chen Cang quickly said, “Let’s supplement iron and conduct a vitamin B12 test to see the effects!”
On the 29th of the lunar month, the aunt suddenly recovered miraculously.
This news made everyone in the emergency room feel emotional.
Old Ma glanced at Chen Cang and couldn’t help but ask, “Cang, how can you know everything!”
[Ding! Diagnosed with Anemic Psychotic Syndrome, difficulty level is high, acquired Neurology Skill Tree Key x1!]
Chen Cang was delighted; is it really that simple?
After clear diagnosis, you can get a key?
And the key happens to unlock skills on the skill tree?
In this case…
Chen Cang suddenly realized, switching careers truly paid off.
However, seeing the difficulty level, Chen Cang frowned slightly; maybe… there’s another clue?
But either way!
Being a doctor means not taking details lightly; we must always stay alert.
Any clue may lead to different results occurring!
When an issue arises, it’s better to get to the bottom of it.
…
ps: I find this medical case very interesting, sharing it with everyone.
Anemia can certainly cause mental system diseases.
Asking for monthly votes since it’s end of the month, everyone please support, I beg!