Tokyo: Let the wicked women pay the price!

This is not due to Fujino's petty intentions.

Psychiatry, especially in private clinics and private hospitals.

We often prescribe mood stabilizers to keep patients calm and make them appear as if they have recovered.

However, real treatment, including lifestyle changes and the remodeling of neurotransmitter mechanisms, is often not carried out.

The reason is also very simple.

Make money.

Making a misdiagnosis without even thinking about it makes it hard not to make related associations.

Kitano Megumi looked at Fujino, but couldn't find a trace of embarrassment on his face.

She was more inclined to believe Fujino, the one who had truly saved her.

"Fujino-san, this is terrifying..."

Panic attack.

"Yes, Fujino-san." Kitano Megumi straightened her suit jacket and sat up straight. "What kind of panic attack is this?"

Fujino pointed to his stomach and slowly said, "The nerves that control the function of internal organs are called the autonomic nervous system. It consists of the sympathetic nervous system, which controls excitement, and the parasympathetic nervous system, which is responsible for maintaining stability."

"Normally, these two aspects are kept in balance in most people. However, due to stress or mental illness, some people's sympathetic nervous system becomes abnormally excited, causing symptoms such as palpitations and rapid breathing, which is a panic attack."

Kitano Megumi held the water that Fujino had given him, her face showing some dissatisfaction.

"Intense heart palpitations... difficulty breathing... Yes, that's true..." Kitano Megumi murmured. "Yes, that's how I am when I have an attack. Now I'm even afraid to ride the train."

Fujino nodded.

Yes, the body remembers the feeling of fear.

Because of repeated panic attacks, the body remembers the "situation that triggered the attack," and this is called "agoraphobia."

This predictable onset of illness can leave the body in a state of prolonged unease.

Patients with panic attacks will forever be trapped in a cycle of "area phobia"—the fear of the place following a panic attack—followed by "anticipatory anxiety" when they anticipate passing through that place, which in turn exacerbates their panic attacks...

"You don't need to worry about it," Fujino said, quickly reassuring Kitano when he saw her hands trembling more violently. "I'll order a neurological examination for you later. If there's nothing wrong, then it's probably just stress from work and life."

"...How could this happen? I'm known as the Iron Lady, a strong woman. Why..." Kitano Megumi said dejectedly.

Does this mean she is a weak person?

Kitano Megumi, who works diligently at the ward office, cannot accept this.

"Ms. Kitano, panic attacks are not caused by inner weakness."

Fujino noticed her slightly clenched fist and the bitter smile on her face.

He read about the persistence of "not wanting to admit one's inner weakness".

"On the contrary, it is usually because the brain receives signals of excessive fatigue, like an engine trying to rev its engine to the last bit of fuel."

He noticed the bewildered look in Kitano's eyes: "To put it simply, it's like your brain is telling you, 'You've already worked so hard, it's time to take a break.'"

Kitano Megumi shook her head: "You don't understand. Someone like me doesn't deserve to rest."

"I am a single mother, and my child needs me to go to work."

Her eyes drooped, and she instinctively clutched her head, muttering unconsciously, "I have to go to work..."

Fujino quickly raised his elbow and gently waved his hand: "Take a deep breath, Kitano-san. Inhale—exhale—exhale—exhale—"

He watched as the woman's breathing gradually calmed down before continuing, "It's not that I'm preventing you from going to work. In fact, it's quite inconvenient for you to ride your bicycle to work every day."

Kitano Megumi nodded slightly, somewhat exhausted: "Do I need to take medicine? I don't want to take medicine."

Did you bring your medication record book?

Taking the manual from Kitano Megumi, Fujino frowned: "The dosage is a bit too high for you."

"Just take it immediately when an attack occurs, and you can temporarily stop taking the medication if you feel better within 20 minutes."

"Your symptoms are not severe."

Kitano Megumi looked confused: "Then why did you prescribe such strong medication for me?"

Fujino knew perfectly well what was going on, but he couldn't say it.

The dosage of psychotropic drugs generally fluctuates within a range that is understood by doctors.

If the maximum dose is always prescribed, there will definitely be no problem.

After taking the medication, the patient was in a drowsy or "cloudy" state every day, emotionally detached, and lethargic.

The illness can usually be controlled, but the medication needs to be taken repeatedly.

The only ones who suffer are probably the patients who gradually lose their emotions.

"Just take the medicine as I prescribed," Fujino waved his hand.

We should help every patient like this we see.

He still needs to make a living in the psychiatric community; there's no need for him to offend everyone.

As soon as Fujino finished speaking, an eerie silence fell over the consultation room.

Kitano Megumi gripped the empty disposable paper cup tightly, her lips moving for a long time before she finally opened her mouth.

Her voice was hoarse as she asked, "Doctor...can I really be cured?"

Upon hearing this, Fujino's expression also turned serious: "Ms. Kitano, I assure you."

"As long as you follow my instructions and the treatment plan, even if you have many more episodes, you will absolutely not be in any danger of life-threatening panic attacks."

"Huh?"

Kitano Megumi covered her mouth in surprise: "Would it kill you to exaggerate like that?"

Fujino smiled gently: "If you remember what I'm saying, your symptoms will gradually improve. Also, remember to take your medication when you have an attack. Remember my smiling face now, and breathe slowly."

"Here's some homework for you." Fujino took a piece of paper and drew a table.

"You should create a table showing the levels of anxiety and the corresponding behaviors. For example, if you feel extremely anxious while riding a tram, that's level 10; if you feel a little anxious while riding an elevator, that's level 6. And so on."

"Start with mild anxiety and gradually awaken the parasympathetic nervous system through deep breathing."

He grinned and gave a thumbs up: "Believe in yourself, everything will be alright."

Ms. Kitano was stunned by Fujino's smile.

They say smiles are contagious.

The worry on her face when she entered seemed to disappear, and the corners of her mouth unconsciously turned up in a smile:

"Hahaha--

"He looks completely dumbfounded."

......

After seeing Kitano Megumi off, Fujino returned to his office.

I happened to run into Assistant Professor Kobe, who was just about to leave work.

"Oh? Fujino-kun, haven't you gone home yet this late?"

"Kobe-senpai, we spent a little too long talking to the last patient." Fujino scratched his head sheepishly.

Upon hearing this, Assistant Professor Kobe paused in his tracks: "Are you in a hurry to go home?"

Seeing Fujino gently shake his head, he smiled and said, "Shall we talk?"

Fujino looked around the assistant professor's office.

The office, a full 15 square meters, is much more spacious than the 2 square meters per person workstation for medical professionals.

Even specialist doctors have a small cubicle of about 6 square meters in the main office of their department.

As Fujino sat on Assistant Professor Kobe's sofa, he couldn't help but wonder when he would finally be able to use this office.

Kobe brought Fujino a cup of coffee: "Fujino-kun, I'd like to ask you for some advice this time."

"Ah?!" Fujino exclaimed in surprise, quickly standing up and bowing. "No, no, Kobe-senpai, what can I do for you?"

Kobe sat on the sofa opposite Fujino, crossing his legs: "What was the patient's condition just now?"

"That young lady is having a panic attack and has some anxiety..." Fujino briefly explained Kitano's condition and how he treated her.

Professor Kobe seemed to be deep in thought, recalling Professor Kasai's question.

Where does the lesion of mental illness lie?

He blurted out, "Fujino-kun, so what do you think is the root of this Kitano-san's problem?"