Chapter 1714: 1655 Almost Misdiagnosed

Have you taken carbamazepine for this episode? Su Yun asked.

I took it, but it's not working well. Ai Pang Lao Ban said: "Maybe he's developed resistance; I'm planning to go to the psychiatric hospital again to get him a prescription."

There wasn't really anything else they could do, and Zheng Ren sighed.

For someone honest and simple like Da Liu, it's truly possible he'll never get out of this for his whole life.

He's single‑minded and stubborn.

"If I'd known Da Liu was so willing to drink, I'd have gone drinking with him a few times to properly advise him." Su Yun felt a bit regretful.

"Back home, Da Liu drank a catty of liquor every day, year after year." Ai Pang Lao Ban said: "Working here, he knows drinking interferes with work, so he only has a couple of liang in the evening, just for the sake of it."

Zheng Ren broke into a sweat—having a couple of liang, is that just to quench a craving?

Ai Pang Lao Ban's phone rang; he answered, said a few words, then hung up.

"He's back, go take a look." Ai Pang Lao Ban said.

"You too—why didn't you come find me earlier? What's the point of looking for me now?" Su Yun complained.

"I just feel stifled inside and want to talk to someone. Yun Ge'er, you say I've been diligent, but Da Liu's brother keeps pressing me for money." Ai Pang Lao Ban was also troubled.

In this deadlock, neither Zheng Ren nor Su Yun could find a solution.

Just thinking about sending Da Liu back to his hometown to be committed to a psychiatric hospital made both Zheng Ren and Su Yun feel gloomy.

"Nothing's wrong, I'll head back first." Zheng Ren said quietly.

Ai Pang Lao Ban was somewhat surprised, and Su Yun scoffed: "My boss is just like that—if he can't solve something, he doesn't want to look at it, a total coward."

Zheng Ren patted Ai Pang Lao Ban on the shoulder, said nothing, and walked in with his head down.

A wheelchair came rolling toward them.

Zheng Ren glanced at it and saw a bright‑red system panel and a different diagnosis.

Subacute subdural hematoma!

He lifted his head and took another careful look.

No mistake! He does have intracranial bleeding.

Zheng Ren quickly walked over to Da Liu and said, "Let me handle it."

Around the wheelchair were two or three people; a young man who looked somewhat like Da Liu was probably his brother.

"Where's the boss?" Da Liu's brother said: "My brother's gone mad—it's definitely his oppression. To squeeze out blood‑and‑sweat money, he's turned my brother into this! Capitalists, they're all damned evil! They're not even human!"

Zheng Ren was a bit annoyed and anxious; he took the wheelchair and rushed it into the emergency resuscitation room.

"Let's go." Seeing Zheng Ren push the wheelchair into the resuscitation room, Su Yun was a little surprised and said, "There's nothing to see."

"Let's check his vitals—I feel something's off with Da Liu's condition." Zheng Ren said hurriedly.

Da Liu sat in the wheelchair, his limbs twitching nonstop, muttering something under his breath.

"Manager Zhou, the patient's back." Zheng Ren entered the resuscitation room and immediately called out, "Has the blood pressure been taken?"

Zhou Litao had just finished, glanced at Da Liu, and said, "It's been taken—120 over 80, pulse about 90 per minute."

"I'll use the flashlight for a moment." Zheng Ren said.

Zhou Litao handed the flashlight to Zheng Ren and said, "The pupillary light reaction is a bit sluggish; otherwise nothing else."

"Has a head CT been done?"

"I'd like to get one for him, but the family objects." Zhou Litao was also troubled.

"My brother isn't injured—you just want to run tests to make money, don't you! I know you get a kickback for tests!" Da Liu's brother shouted from behind: "In the capital, there's not a single decent person!"

Zheng Ren ignored Da Liu's brother, took the flashlight, and began examining Da Liu's pupils.

Just as Zhou Litao said, both pupils reacted weakly to light, with the left one slightly dilated.

"Strange, I didn't see any pupil dilation earlier." Zhou Litao wondered, "Could it be a subarachnoid hemorrhage?"

"Not necessarily—let's get a CT first to see." Zheng Ren said.

"Okay."

Zhou Litao agreed promptly and sprinted off to write the order.

Da Liu's brother was still gripping Ai Pang Lao Ban on the side, nagging about money.

Soon, Zhou Litao came out with the CT requisition and handed it to Ai Pang Lao Ban.

"You go pay, I'll find someone to send him for the test." After saying that, Zhou Litao called for an attendant and another doctor to take Da Liu for the examination.

"What test? Just wasting money!" Da Liu's brother snatched the CT request form, tore it up, and said, "You keep doing one test after another, but it's all the same in the end—my brother ended up like this because of you all!"

This is basic troublemaking; Zheng Ren has seen it all the time in Hai Cheng and is no longer surprised.

Zhou Litao said sternly: "The patient—your brother—could possibly have an intracranial hemorrhage. If you don't do a CT and something happens to him, you'll bear legal responsibility; that's intentional homicide."

"You—" Da Liu's brother still wanted to argue.

"There are cameras, so our conversation is recorded. If you refuse and your brother really comes to harm, you'll definitely be thrown into prison—that's intentional homicide!" Su Yun deliberately spouted nonsense to scare Da Liu's brother.

Hearing Su Yun say that, his bravado deflated. He feigned ferocity, glaring at Zhou Litao and Su Yun, then waved his fingers weakly twice, said nothing harsh, and turned and walked away.

Zhou Litao didn't mind either; he went back, wrote another order, gave it to Ai Pang Lao Ban, and told him to get the CT done. He also specifically instructed the emergency doctor accompanying them that if there was bleeding, they should be sent straight to neurosurgery.

After everyone left, the emergency department fell temporarily silent.

Since the internal medicine doctor from the emergency department took Da Liu for the test, Zhou Litao had to handle outpatient duties.

At this time it wasn't very busy; there was a doctor inside who didn't yet need Zhou Litao.

"Zheng Lao Ban, Yun Ge'er, how do you have time to come down?" Zhou Litao asked.

"We know the patient—he's the chef at the restaurant where we usually eat." Su Yun said: "Who would have thought he'd have an intracranial hemorrhage?"

"At least it's better than a psychiatric disorder." Zheng Ren said.

"Good thing Zheng Lao Ban came down, otherwise we might have missed it." Zhou Litao felt a bit of lingering fear, chuckled, and said: "When I arrived I examined him—there really was no pupil dilation. Besides, he has no history of trauma, his blood pressure isn't high, so we hadn't considered intracranial hemorrhage."

"I know." Zheng Ren said: "Subdural hematoma can occasionally appear in patients with minor trauma; the emergency department keeps them under observation precisely because we worry about this kind of problem."

"Symptoms only appear after three days to three weeks, sigh." Zhou Litao sighed; the Emergency Department is tough, and that shows up here.

Do too many tests and the patient's family is unhappy; do too few and the patient suddenly shows a symptom change, leaving them flustered instantly.

Like Da Liu, based on the chief complaint, it's clearly alcohol intoxication, epileptic psychomotor seizure. With a psychiatric diagnosis, the family refuses a head CT, so the chance of misdiagnosis has shot through the roof.

If Zheng Ren hadn't taken a look, Da Liu would probably soon develop brain herniation.

By then, doing Shou Bing would be much less effective.

……

……

Note: When leaving the emergency department, I often encounter patients' families who refuse to undergo examinations. I also have a mild obsessive-compulsive disorder; when encountering such situations, after the patient leaves, pessimistic feelings spread, and I fear something will happen. It's quite... agonizing...