“Sister Ma, you should get a check-up. A constant headache is something to be worried about.” The person accompanying the patient looked to be a good friend.
The patient looked to be in her forties and there were clear signs of age on her face.
She held a medical ticket in her hand. From the look of it, she was searching for the payment counter.
Zheng Ren quickly called out, “Hey! Hold up!”
The patient and her friend carried on chatting as they moved toward the payment counter. Zheng Ren’s shout went unnoticed.
Zheng Ren quickened his steps and overtook them. He blocked their path and said, “Miss, I’m the chief resident of the emergency department. You’re here about a headache?”
The patient was taken aback by the sudden appearance of this stranger. Nevertheless, she answered, “Yes.”
Zheng Ren softened his voice and expression. “What tests are you scheduled for?”
The System’s luck points or charm points made him appear reliable to the two women.
The patient handed over Zheng Ren the slip of paper.
He looked through the paper and saw a head MRI scan was ordered. That was concerning.
Luck was truly on his side!
At this moment, Zheng Ren was witness to the miracle of having +8 luck points.
“I don’t think this test is suitable for your condition. I overheard some of your conversation just now; the cost of the test is an issue?” Zheng Ren said bluntly.
“Why, yes. 500 yuan for a scan is quite a burden,” the patient said with a frown.
“Come on, let’s get the Old Chief to have a look at you,” Zheng Ren said smiling, guiding the patient and her friend to Old Chief Physician Pan’s office.
After two raps on the door, Zheng Ren entered the office without waiting for a response. The unusual entrance put Old Chief Physician Pan on alert, but he played along with Zheng Ren’s ruse.
There were many ways to proceed with the medical examination.
A routine examination performed in the emergency department had to be simple as they often had a dozen or more patients waiting in line. Taking more than 30 minutes per patient was not feasible.
If the patient’s condition was not critical, the patient would be sent for other medical tests after a simple physical examination.
This way, the steady stream of patients could be controlled and redirected to other parts of the hospital.
Anxiety was infectious, especially among patients.
The graying hair combined with his austere demeanor made Old Chief Physician Pan appear more legitimate than Zheng Ren. The Old Chief performed a detailed physical examination on the patient.
Zheng Ren brought the patient to Old Chief Physician Pan for a reason.
As he performed the check-up, Zheng Ren started to explain.
“Chief, this patient has a chronic headache; this bout is more severe than usual, hence she came to the hospital. She was sent for a head MRI scan, but because of her financial background, I want to suggest a head CT scan.”
The explanation was sufficient to give Old Chief Physician Pan some indication of what Zheng Ren was planning.
Old Chief Physician Pan maintained a neutral expression and continued examining the patient for five minutes. Then, he said calmly, “I don’t see any major issues. We’ll have a clearer picture with a head CT scan. That’ll just cost 120 yuan.”
The patient was grateful for their help. Although the advice was different from the emergency medicine doctor’s original order, Old Chief Physician Pan’s age and wisdom was convincing. The two women left the office with a medical ticket for a head CT scan issued by Zheng Ren.
Before they left, Zheng Ren even gave them his contact number so they could call him once the CT scan was done.
After the patient and her friend left, Zheng Ren let out a relieved sigh.
Old Chief Physician Pan raised a curious eyebrow at Zheng Ren. “What are you worried about?”
“Chief, I suggested a head CT scan for this patient because it would be safer. An MRI scan would be disastrous if she had metal in her skull,” Zheng Ren said somberly.
Old Chief Physician Pan understood Zheng Ren’s concern.
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Why would there be metals in the skull?
The everyday person might not be able to comprehend how metals could be lodged in the skull, but as a field doctor who spent years in the war zones of Southern Xinjiang and the Northern Borders, this was not a surprise for Old Chief Physician Pan.
The old chief nodded and said, “You’re right. Let me look into our procedures and remind the doctors about this.”
Zheng Ren was glad to have Old Chief Physician Pan as a superior. New suggestions and feedback were never taken as signs of disobedience.
After that was settled, he excused himself from the Old Chief’s office. Zheng Ren took out his phone and continued texting Chang Yue and Su Yun. There was a dinner tonight that required their drinking prowess.
Zheng Ren was terrible at all these non-medical things.
However, Old Chief Physician Pan was able to shore up his weaknesses. They worked together well as a team.
When Zheng Ren arrived at the emergency ward, Su Yun was waiting for him. The taunts rained down on him like hellfire.
The group chatted for about an hour when Zheng Ren’s phone rang. The patient from earlier had undergone the head CT scan and was waiting for the physical copy of the scan.
Zheng Ren described the layout of the emergency ward and told her to bring the scan over. He instructed her to tell the technician Dr. Zheng wanted to have a look at the scan and that the report could be collected later.
After ten minutes, the patient came to Zheng Ren with the scan.
The scan was placed on the viewer and, upon closer observation, Zheng Ren saw the three metal needles embedded in the patient’s skull.
The image sent a shiver down his spine. The needles were like the devil’s teeth, gripping the patient’s head firmly in its jaw.
“Damn…” It was the first time Su Yun had witnessed something like this. He was just teasing Zheng Ren about making mountains out of molehills, but the arrival of the scan really shut him up.
Professor Rudolf Wagner walked over and glanced at the scan. Foreign objects in the body were uninteresting to him and he went back to his table to work on the draft for the TIPS surgery methods and differential diagnosis.
Chang Yue and the others were equally as shocked as Su Yun.
If the patient were to undergo an MRI scan…
Metals interacted with the magnetic field that was generated by MRI machines.
Hence, any item that was remotely metallic was not allowed in the MRI room.
Once, a wheelchair was pulled into the MRI machine in Sea City General Hospital and the staff had such a difficult time prying them apart.
Patients who underwent stent surgeries and fracture fixation surgeries were disallowed from using the MRI machine.
These days, Nitinol was the metal alloy of choice in medical devices as it was considered MRI safe.
If the patient had gone through the MRI scan, the needles in her skull would have been tugged on by the strong magnetic fields.
The patient’s brain…
The outcome would have been unimaginable. The thought made every doctor in the room shudder.
“Chief Zheng, how did these get in?” Chang Yue asked as she wrung her hands.
“It probably happened when the patient was young,” Zheng Ren said quietly.
The human skull goes through various developmental stages. During the first few months of a baby’s life, the skull is soft and malleable and it would not be difficult for needles to puncture the skull.
Decades ago, girls born in rural areas were mistreated and incidents like these were common throughout the country. Despite the stories, Zheng Ren had never encountered a needle-in-the-head case until now.
The patient might not understand the technical aspects of a CT scan, but the contrast of the metal needles was clear against the black background.
“When did you start experiencing the headaches?” Zheng Ren asked.
The patient’s expression was a blend of surprise and bewilderment. “Since I was young.”
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