Chapter 153: 【153】Sometimes the patient’s family is more nervous than the patient.
“Okay, you said her heart rhythm is irregular, where in the ECG does it show there’s a problem?”
Zhao Zhaowei furrowed his brow and tried hard to recall the patient’s ECG he had just reviewed, “There are, there are more than one P wave, this is——”
“Do you think it’s sinus arrhythmia, yes or no? Confirm it.”
Zhao Zhaowei felt like crying again. Even diagnostic textbooks and internal medicine textbooks didn’t seem to explain ECGs in such detail.
“Teacher, I don’t know.” Zhao Zhaowei admitted defeat once more.
“If you perform an ECG but can’t identify the problem on it, what do you think that means?”
“It’s my fault.” Zhao Zhaowei surrendered for the third time.
Doctor Lin turned to ask Xie Wanying, “What do you think?”
“Performing an ECG but not being able to detect the issues within it is quite common, since many heart diseases are latent. To come to a conclusion, relying solely on an ECG is not enough. Moreover, the ECG itself can be affected by many objective factors. For example, the patient’s emotional state. In this female patient’s case, it is clearly respiratory sinus arrhythmia, which is a common presentation in adolescents, characterized by a PP interval larger than 0.12 seconds. She was also very nervous during the test. However, it’s important to note that the patient was brought to the emergency room because she felt palpitations and dizziness leading to fainting; other diseases should not be easily excluded.”
After hearing Xie Wanying’s words, Zhao Zhaowei remembered, “Right, it’s not that there are more than one P wave, it’s that the PP interval is prolonged.”
Doctor Lin, of course, knew sinus arrhythmia was correct; otherwise, he wouldn’t have asked the student. He was interested in what Xie Wanying said afterward, “What other possibilities do you think could have caused her fainting?”
“Apart from conducting further cardiac examinations, start with a blood test, rule out thyroid dysfunction, rule out potassium issues, and check if she has taken any medication that could affect her body. Let’s do a comprehensive check-up,” Xie Wanying said, looking at the patient, truly feeling she couldn’t see any significant problems with the female student. If there had to be a problem, it was possibly with the parents waiting outside, given their older age.
Doctor Lin knew her thoughts by her expression and walked away with a slight smile. Essentially, Xie Wanying’s judgment aligned with his.
High school seniors, parents are always more nervous than their children. So, Xie Wanying was right; conducting a comprehensive check for the patient was also being responsible to the overly anxious parents.
Seeing the teacher leave, Zhao Zhaowei and Xie Wanying moved aside, him wiping off sweat, “Yingying, could you in the future——”
“How about, I just avoid being together with you in the future.” Xie Wanying also knew that having been reborn gave her an advantage over Zhao Zhaowei, which was unfair to him and the others.
Unexpectedly, upon hearing this, Zhao Zhaowei grabbed her hand earnestly pleading, “No, no, no. Please don’t do that. You have to realize, these past few days in neurology, I haven’t had the chance to get hands-on experience, nor would I know what I’m doing wrong. Because the teacher doesn’t seem enthusiastic when they see me.”
Teachers in clinical settings are very different from those giving lectures. Most are too busy treating patients every day, haven’t been trained in pedagogy, and don’t have the oratory skills to teach. If they say a few words and perceive that the students don’t understand, they certainly won’t say more; speaking would be a waste of words, like talking to a duck if you’re a chicken. Getting clinical teachers to speak more takes a student like Xie Wanying, who is at that level.
Doctor Lin was willing to talk more because Xie Wanying made him feel like he was discussing academics with a colleague, a very pleasant feeling.