White armor

Chapter 745 The medical records from the Qing Dynasty are also in the medical record database?
"Come on, let's grab something to eat." Chen Yan pulled Luo Hao along. "I'm different from you. My blood sugar gets all messed up when I get even a little nervous. So I'm taking on fewer and fewer major surgeries. Standing for seven or eight hours straight is too much for my body."

"Director Chen, you're exaggerating," Luo Hao said with a smile. "There have indeed been far fewer doctor-patient disputes in recent years..."

He had barely finished speaking when Chen Yan stopped him.

"Xiao Luo, what did you just say?"

"I said that there have indeed been fewer medical disputes recently, to the point that many mid-level doctors have no experience in handling medical disputes. Especially some newly promoted directors in tertiary hospitals, they don't know how to do things."

"Oh? Who are you?" Chen Yan was about to ask when he immediately remembered that Luo Hao used to be an officer in the general medical department of Donglian Mine, and this might be feedback from Donglian.

“Yes, it was my uncle who told me.” Luo Hao also said with a bit of helplessness, “Since we’re on this topic, let’s chat for a bit. I feel that the main reason is that many elderly patients with complex complications died from pneumonia in previous years, and the patients we are treating are relatively simple, which is the result.”

"There probably aren't that many," Chen Yan thought, finding Luo Hao's opinion problematic.

"I don't know the specifics, but that's what my uncle said, and I think it makes sense. As a result, the new director seems to have a childish attitude, leading to many inexplicable medical disputes."

"And then? What were you going to say?" Chen Yan continued to ask, not wanting to say too much about it.

Luo Hao thought for a moment, then shrugged, "Hey, I forgot too. All I could think about was AI robots. I just mentioned it to you without thinking."

"Look at you." Chen Yan didn't press further; it was just casual conversation.

“Speaking of medical disputes, something comes to mind. When I was young… Xiao Luo, I’m testing you.” Chen Yan stroked his beard and said with a smile.

"Director Chen, please go ahead."

"When I was young, I performed an appendectomy. When I went up to open it up, I couldn't see any inflammation in the appendix. What if I just cut it open carelessly and the patient was still in pain after I left the operating room? I was completely panicked. To be honest, I was sweating profusely."

Luo Hao smiled, and in just a moment he had a rough guess in his mind.

"What would you do if it were you?" Chen Yan seemed casual, but this question actually contained a deep pitfall.

"First, rupture of the right ovarian follicle. This is more common in young women. After the right ovarian follicle ruptures and bleeds, it can irritate the right peritoneum and cause pain, which may be accompanied by vaginal bleeding. The pain usually occurs between two menstrual periods."

"second……"

Luo Hao started explaining the differential diagnosis, counting on his fingers.

Chen Yan sighed deeply. Xiao Luo's basic knowledge was really solid. Appendicitis looks simple, but it actually needs to be differentiated from many other diseases.

"Eighteenth, abdominal purpura. It is characterized by paroxysmal colic around the navel and in the lower abdomen, without migratory right lower quadrant pain or muscle tension. There is a history of drug allergies, and petechiae may be seen on the skin and in the mouth."

Luo Hao also mentioned extremely rare conditions such as ACS, right lower lobe pneumonia and pleurisy, right ureteral stones, acute mesenteric lymphadenitis, and intestinal ascariasis.

"Alright, alright, stop talking." Chen Yan quickly stopped him. If they continued, he was afraid Luo Hao would talk until dawn.

"Appendicitis should not be taken lightly; there are more than 30 differential diagnoses."

"Tsk tsk." Chen Yan clicked his tongue in amazement. "Xiao Luo, you're amazing. Is everyone at Peking Union Medical College Hospital like this, or is it just you?"

"I'm nothing special at Peking Union Medical College Hospital, just an ordinary doctoral student," Luo Hao said with a smile.

Chen Yan cursed inwardly, "That bastard Luo Hao."

If he's just an ordinary person, then there are no amazing people out there. An ordinary PhD student? How dare he even say that?

"By the way, Director Chen, since there's an exam, I've prepared a question for the students. Could you please take a look at it for me?"

"Oh? Go on." Chen Yan immediately became alert, perking up his ears, determined not to miss a single word Luo Hao said.

"During the Qing Dynasty..."

"Wait a minute!" Chen Yan interrupted Luo Hao, "You said it's the Qing Dynasty? Are you sure it's the Qing Dynasty?"

"Yes, I found some interesting medical records stored in the Peking Union Medical College Hospital's medical record database, so I took them out to show my students this year."

"..." Chen Yan remained silent.

That chilling feeling had already fully emerged.

Medical records from a hundred years ago—did doctors still keep these kinds of records back then?

Let alone more than a hundred years ago, even now, the doctors under my care are unwilling to record the course of a patient's illness.

Everyone says it's useless; even when forced to write, most people just do a perfunctory job.

But now that Luo Hao has produced medical records from the Qing Dynasty, Chen Yan is filled with longing. The century-old heritage of Peking Union Medical College Hospital is indeed extraordinary.

"On the 14th day of the ninth lunar month in 1908, the patient underwent his first examination. He frequently suffered from incontinence, headaches, fever, spinal pain, and loss of appetite. His lower back was clearly afflicted."

In addition, his lungs were not in good condition, suggesting tuberculosis, but without a detailed examination, a diagnosis could not be made.

His face was pale and bloodless, his pulse was very weak, and his heart was also weak.

His physical constitution was not strong to begin with; he was of a nervous and sensitive nature. In addition, he had been indulging in excessive sexual activity in his early years, which had caused him to suffer from back pain for a long time. He could not resist stimulation. Even the slightest vibration to his nerves, such as the sound of gongs and drums, the friction of clothing, or occasional sexual stimulation, would cause him to ejaculate prematurely.

The eyes could not tolerate tonics; the more tonics the patient took, the more frequent the seminal emission became. I then asked the patient to provide urine samples for testing.

Luo Hao simply recounted the medical records from a hundred years ago.

Although this medical record is not considered standard, back then doctors probably recorded whatever they saw, which, in today's terms, means they weren't formally trained.

But this content alone is enough for Chen Yan to ponder for a while.

Chen Yan carefully studied the medical records Luo Hao had provided and had already formed several diagnoses in his mind.

But he didn't say anything; he just listened quietly.

"I have been examining him for over a month, and the medicine has been effective. I have seen a reduction in his lower back pain and seminal emission. However, an examination of his urine revealed a small amount of protein, which is sufficient evidence of lower back pain."

"On October 18th, I returned to the hospital. On that day, I suddenly suffered from stomach pain, rolled around on the bed, and cried out to me, 'My stomach hurts terribly.'"

All the traditional Chinese medicine doctors had left, leaving only one or two attendants. I observed that the patient was unable to sleep at night, had constipation, a rapid heartbeat, a dark complexion, and a yellow-black tongue. Most unusually, the patient frequently complained of abdominal pain, which was unrelated to the previous illness.

He suggested applying warm water to the abdomen.

Luo Hao's next statement was somewhat vague, seemingly omitting some details.

"Actually, the translation is quite simple: the patient has a history of diarrhea, headache, fever, back pain, indigestion, and other illnesses, with suspected pulmonary tuberculosis. Physical examination revealed anemia, weak heart sounds, and decreased peripheral vascular pulsation. Diarrhea can be triggered by psychological stress, such as the sound of gongs or drums, or friction from clothing."

Medication was administered, but the specific medication is unknown. The patient's lower back pain and diarrhea symptoms improved. Finally, there wasn't much else that could be done but to apply a warm compress to the abdomen.

"Uh~~~"

Comparing the before and after, Chen Yan was stunned.

These medical records from the Qing Dynasty are quite interesting.

"The patient passed away three days later," Luo Hao said finally. "The doctor wasn't with him when he died. Director Chen, what illness did you diagnose the patient with?"

Chen Yan keenly noticed Luo Hao's upturned lips, as if he was laughing at Chen Yan for not being able to come up with a diagnosis.

He pondered it carefully, treating this "question" as a contest between himself and Luo Hao.

After thinking for about three minutes, Chen Yan said, "Xiao Luo, I think the patient's clinical symptoms are caused by acute renal failure, and he will soon die from renal failure."

"If we don't know the patient's identity, this is the only diagnosis we can make," Luo Hao said with a smile.

"Identity?" Chen Yan frowned, repeating the key point in Luo Hao's words.

"Didn't you notice that the doctor didn't prescribe any medication in the end, but only told you to apply a hot compress to your abdomen?" Luo Hao reminded Chen Yan.

Chen Yan was completely stunned. What did this have to do with the patient's diagnosis and treatment?
"The patient was Emperor Guangxu of the Qing Dynasty."

"!!!" Chen Yan was stroking his beard when he accidentally pulled out a tuft.

It was actually the Guangxu Emperor!

"It has been tested now, and there is a large amount of arsenic in Emperor Guangxu's hair. It is considered that he died of arsenic poisoning," Luo Hao said.

"Really? Is this some kind of unofficial history?" Chen Yan asked. "There's all sorts of unofficial histories going around these days, they call it something like 'ditch literature,' I don't really understand it. Anyway, no matter what the topic is, there's always a ton of unofficial history. Hahahaha."

"Haha, Director Chen, look at you, you really are an expert. You even know how to talk about Emperor Guangxu's illness," Luo Hao praised.

"I'm not being sarcastic, I'm serious," Chen Yan said. "Xiao Luo, is it true that Emperor Guangxu was poisoned by arsenic?"

"Indeed, in 1980, the state carried out renovations on the tomb of Emperor Guangxu. During this period, some of Emperor Guangxu's hair and bones were sent to other places for preservation."

Because Emperor Guangxu's tomb had been looted in the 1930s, by the 1980s, only his hair and bones remained of his body.

Therefore, researchers conducted trace element tests on Emperor Guangxu's hair and remains, and unexpectedly discovered a significant increase in arsenic content in the middle section of his braid.

In comparison, the arsenic content in the hair of Emperor Guangxu's empress was 261 times higher.

At the same time, this concentration was significantly higher than the arsenic concentration reported in domestic patients with chronic arsenic poisoning, being 66 times higher. The middle section of her braid was pressed under her body at the time, corresponding to her abdomen.

Subsequently, researchers examined Emperor Guangxu's undergarments and found the highest concentration of arsenic in the area corresponding to the stomach region. They speculated that this was because the decomposition of the stomach caused a large amount of arsenic to seep into the clothing and subsequently into the hair braid.

Chen Yan immediately understood what Luo Hao meant by what he had said earlier.

The doctor who recorded the course of the illness must have been an imperial physician, someone of the highest caliber, probably similar to Boss Chai.

At that time, it should have been after the Hundred Days' Reform that Emperor Guangxu was imprisoned by Empress Dowager Cixi. Later, Cixi was in poor health and poisoned Emperor Guangxu before she died.

But these were all just rumors, and Chen Yan always felt they couldn't be taken seriously. Although the rumors were detailed and detailed, they were ultimately just unofficial history, just like the relationship between 101 and the Emperor—neither of them were credible.

But Xiao Luo said there was national-level testing, so if that's the case, the rumors circulating around the world do have a little bit of credibility.

During the Hundred Days' Reform, what could a court physician do in the power struggle between the Empress Dowager and the Emperor who ruled from behind the curtain?
In the end, he refused to prescribe any medicine, only advising on hot compresses, truly demonstrating the ruthless and unscrupulous nature of the old attending physician.

To avoid others blaming me, and to prevent the poisoning from being caused by my own medicine.

In fact, more than a hundred years ago, in the early 20th century, he wrote medical records documenting his treatment of Emperor Guangxu, just in case.

Chen Yan was momentarily at a loss, pondering the medical records of Emperor Guangxu before his death and the treatment plan of the imperial physicians, feeling a mix of emotions.

“The students have never seen arsenic poisoning before, so I specially chose this medical record to test them. It’s called a test, but actually it’s to let them know that medical records existed a hundred years ago, and that recording medical records is a must when they become doctors in the future.” “Uh…” Chen Yan was speechless.

He never expected that Luo Hao would later manage to smooth things over.

"The imperial physician back then was a wise and intelligent man. Since the palace records are no longer verifiable, why did he record them himself?" Luo Hao asked.

"I can probably guess," Chen Yan said.

"Yes, that's roughly what happened. This is one of the earlier potential medical disputes, and a top-level one at that, the kind that could easily lead to death. Not to mention today's students, even the current attending physicians and department heads are not aware of medical disputes. How can this be allowed?"

"Although these are all internal contradictions among the people, who is willing to bear the consequences, don't you think?"

When Chen Yan heard Luo Hao finally bring the topic back to the beginning, he sighed softly.

“There’s been a saying in our classmates’ group lately: ‘In the past, the Premier studied for the rise of China; now we’re studying like crazy so that we won’t be left behind in the rise of China.’”

"Hahaha." Chen Yan laughed loudly.

But his laughter gradually faded, and he seemed somewhat lost.

This is no joke. The rise of China is a collective matter; it can only raise the lower limit, but it can never raise the upper limit.

Who in Luo Hao's WeChat group cares about such low moral standards? Do they want to be helped by poverty alleviation cadres?
Nonsense.

"I still have to roll this up," Chen Yan thought to himself.

"How did Shen Zi's child do in the college entrance examination?" Chen Yan asked.

"I recommend applying to Peking Union Medical College."

"!!!" Chen Yan exclaimed in surprise, "What? Shen Zizai's son has such good grades?"

Chen Yan's tone had changed, sounding somewhat resentful.

"Yeah, Yifei is very smart, and the director is very attentive to him. I think the director was almost depressed before the college entrance exam," Luo Hao said with a smile, excluding himself from the conversation.

The two changed their clothes and agreed to meet in the parking lot.

Luo Hao greeted Meng Liangren, then obsessively reiterated that he should call him immediately if anything happened. He then patted Erhei's head and headed straight for the underground parking lot.

Beside the car, a tall, thin figure paced back and forth.

Luo Hao frowned slightly and looked over carefully. The man was not old, only in his early twenties, and his eyes revealed a clear stupidity.

His eyes, untainted by society, were as clear as his student ID.

Are these medical students about to fail their exams? The exams haven't even started yet. Are they trying to pull some strings with me beforehand?

Luo Hao walked over, guessing as he went.

Only when he got close did the boy see Luo Hao.

"Teacher!" The man stood at attention, bowed, and was extremely reserved, like a mouse seeing a cat.

"Did you need something from me?" Luo Hao asked with a smile and gentle tone.

"Uh...it's nothing, I just said hello, I'm leaving now." The boy was already in a confused state, talking nonsense, bowing again, and turning to run away.

"Don't go." Luo Hao put his hand on his shoulder. "You've come all the way from the medical university to the affiliated hospital's parking lot, haven't you? Just say what you have to say, otherwise you've wasted your trip."

"..."

The boy looked flustered and confused; Luo Hao could even see sweat starting to bead on his forehead.

"Am I that scary?" Luo Hao said with a chuckle. "Relax, have a smoke."

"No... I'll smoke."

"Should we smoke or not?"

"Teacher, I smoke."

The boy stammered.

"Have a cigarette." This time, Luo Hao didn't take out his own phone to smoke, but instead took the Ziyun cigarette from his male classmate and put it in his mouth, waiting for his classmate to light it for him.

After taking a puff of his cigarette, the male student seemed to feel a little better.

"What do you need me for?" Luo Hao asked with a smile.

Whether it was Luo Hao's attitude or the effect of nicotine, the male student calmed down a little.

"Teacher, I want to take the postgraduate entrance exam this year, but as I study, I feel like it's meaningless." The male student spoke his mind. "I've listened to your lectures, and they look simple, but I can't even do the basic action of 'pinching a balloon with a needle.' Do you think I'm too stupid?"

"Then take your time. It's not that difficult to prick a balloon with a needle. You'll get better with practice."

“Teacher, I’m a bit confused. A few days ago, a graduate student from the Medical University of Lüda died. He was about to graduate, but he committed suicide. He scored nearly 390 points on the postgraduate entrance exam, so he was considered a top student.”

So that's what it was about. Luo Hao sighed inwardly.

Some teachers treat students like animals, completely disregarding their feelings.

Graduate students are a little better off, but for doctoral students, if the supervisor says they won't let them graduate, they really won't. They just want to keep them as free labor for another year or two. As for the students' future, those cunning old foxes don't consider it at all.

"Teacher, what would you do if you were in my shoes?" the male student asked a vague question.

"Me? Bosses are all vying for me, I don't need to worry about graduating," Luo Hao replied calmly.

"..."

The male student had never heard such a Versailles-like statement before and was immediately stunned.

"Hahahaha." Luo Hao laughed loudly, "Everyone has a weakness. Go and poke your mentor's weakness. You don't need to leave a suicide note saying you'll haunt him even as a ghost. If you have that kind of spirit, why not just jump off a building with your mentor in your arms?"

"what?!"

The male student was surprised that Luo Hao gave such a strong answer.

"Just kidding, let's start from the beginning." Luo Hao put away his playful expression, and the male student realized that Teacher Luo was indeed joking, so he finally started to listen seriously.

Seeing his expression, Luo Hao sighed inwardly; children are so innocent.

That last sentence is the best way to resolve this issue. Trying to reason with a bad person? You'll face many obstacles in the future.

However, Luo Hao didn't lead the male student into anything shady. Instead, he said, "Why study? I hope that one day you will use your own independent judgment to solve problems and understand life and society. Don't you agree?"

"Correct."

Luo Hao smiled, thinking, "These kids in the ivory tower are so easy to fool."

"Initially, taking the postgraduate entrance exam might have been a way to give yourself some recognition, since top-tier hospitals in third-tier cities now require a postgraduate degree or equivalent qualifications such as residency training. But actually, taking the postgraduate entrance exam isn't even the beginning of your life. The best outcome is that through studying, you can improve your judgment to a whole new level."

Luo Hao's words confused the male student.

"Let me put it this way," Luo Hao said with a smile, no longer intending to maintain the facade, "you think that getting all tangled up might not necessarily lead to a good outcome in the end, right?"

"Yes!"

One sentence struck a chord with the male student.

"I was just chatting with Director Chen, and he said something that resonates with your current state of mind. I'll share it with you."

The male student pricked up his ears and listened carefully.

"In the past, the Premier studied for the rise of China; now, he studies so that China's rise will not leave you behind."

His clear yet foolish gaze seemed vacant.

"The government can only provide you with a minimum standard. If you want a good life, a better life, how can you do it without putting in a lot of effort? I've seen poor households in rural areas who just roast and eat whatever poverty alleviation cadres bring them. I don't think you want someone to help you with poverty alleviation in the future, do you?"

"Uh, um." The male student nodded.

"So, please do your best. Of course, doing your best is the least important thing, because it's something you can control yourself."

"Then what is it that I can't control?" the male student asked, bewildered.

“It’s luck,” Luo Hao said earnestly, straightening his chest as he felt the warmth emanating from the bronze magnifying glass in his chest cavity. “Once you’ve experienced enough, you’ll realize that luck is the core competitive advantage. It’s that 1, while your efforts are adding more 0s after that 1.”

Seeing that the male classmate wanted to laugh, Luo Hao knew he was making suggestive remarks, so he reached out and tapped him on the head.

"Don't think nonsense, I'm talking to you about something serious."

"Yes, yes, yes, please go ahead, teacher."

Luo Hao noticed that he didn't quite understand. After all, the older you get, the more you believe in luck, and at his age, he was just like a newborn calf that wasn't afraid of tigers.

"One of the physical examinations is a simulated biceps reflex test, you know?"

"know."

The biceps reflex is the reflex that occurs when the biceps tendon is tapped, resulting in elbow flexion. The afferent nerve is the sensory fiber within the musculocutaneous nerve, the reflex center is the gray matter of the C5-C6 spinal cord, the efferent nerve is the somatic motor fiber of the musculocutaneous nerve, and the effector is the biceps brachii muscle.

The examination method is as follows: the patient is seated, the examiner supports the patient's elbow with his left hand and supports the patient's forearm with his left forearm, and then presses the patient's biceps tendon with his left thumb and taps the thumb with a percussion hammer.

Normally, the arm will bounce.

During the examination, if the above reactions are excessive, weakened, or absent, it indicates an abnormal biceps reflex.

This is the most basic check.

“Come on, let’s give it a try.” Luo Hao raised his hand.

The male student was a little confused; he really didn't know what Luo Hao was going to do.

(End of this chapter)