This miracle doctor just wants to be fired!

Entering the emergency room.

The girl on the hospital bed remained lying quietly.

The waveform on the electrocardiogram monitor was stable, much more so than before.

Zhou Chengxian walked to the monitor and quickly scanned the various data.

Heart rate 65 beats/min, blood pressure 85/55 mmHg, blood oxygen saturation 96%, respiratory rate 18 breaths/min.

Zhou Cheng turned to Chen Xi and Li Yang and said, "Make a note of this: compared to before, the vital signs are more stable, but the blood pressure is still low. We need to continue to monitor the fluid resuscitation."

"Received." Chen Xi and Li Yang both nodded.

After speaking, Zhou Cheng bent down and carefully listened to the patient's heart and lungs with a stethoscope. Then he pressed on the patient's abdomen and asked the family members who were watching over her, "Has she said anything about feeling unwell? Has she started talking to herself or saying she's seeing anything again?"

The woman standing by the bed quickly shook her head: "He didn't say he was uncomfortable, he just kept his eyes closed, moved occasionally, and didn't talk nonsense anymore."

Zhou Cheng nodded, then reached out and touched the patient's limbs to check their temperature. He explained to the two people beside him, "We need to focus on observing the patient's level of consciousness, pupil changes, and limb circulation. These can reflect whether the condition is stable. You two try to feel her pulse and limb temperature, and compare it with that of a normal patient."

Chen Xi and Li Yang immediately stepped forward and took turns examining the patient, carefully recording their findings as they went.

Li Yang then asked in a low voice, "Teacher Zhou, her limbs are a bit cold. Is that related to her low blood pressure?"

"That's right. Low blood pressure can lead to insufficient blood supply to the extremities, resulting in cold extremities," Zhou Cheng confirmed his question.

He then turned to the family members: "I'd like to ask you a few more questions. Please think carefully before you answer."

"The patient's emotional disturbances began after the final exams. Specifically, how long after the exams did they begin?"

"Besides being irritable, spacing out, and talking to yourself, have you mentioned feeling physically unwell, such as having a headache, chest tightness, or insomnia?"

The man frowned as he recalled, "It was probably three or four days after the exam that things started to go wrong. He hadn't mentioned feeling unwell before, but he had mentioned a few nights of insomnia, tossing and turning. We thought it was just the stress of the exam and didn't take it seriously."

The woman added, "Another time, she said she felt tightness in her chest. I touched her forehead and she didn't have a fever, so I told her to rest for a while. She didn't mention it again, and we forgot about it."

"Has she ever been diagnosed with any illnesses before? For example, heart disease, high blood pressure, or a history of mental illness? Does she have a family history of similar illnesses?"

Zhou Cheng continued to press for more information, as it was crucial for ruling out underlying medical conditions and identifying the cause of the illness.

The man answered confidently, "No, I've always been in good health. My annual checkups have always been normal, and no one in my family has any serious illnesses."

Zhou Cheng then inquired about the details of her jumping from the moving vehicle: "When she jumped, did she say anything to you? Or did she have any particular expression? Like crying, laughing, or being very calm?"

The woman's eyes welled up with tears again when this was mentioned.

"She didn't say a word, her expression was blank, like she hadn't woken up yet, and suddenly she reached for the car door. If my husband hadn't reacted quickly, I don't even want to think about what would have happened."

Chen Xi and Li Yang were taking notes rapidly, meticulously recording every detail of the supplementary questions in their notebooks, afraid of missing any crucial information.

After seeing that the two had finished taking notes, Zhou Cheng instructed the family members, "If she wakes up and says she feels uncomfortable, or if she starts talking to herself or becomes agitated again, be sure to call us immediately."

"Also, don't stay here and endure it all. Just one of you can stay and rest. There will be a lot of things that require your cooperation later."

"Okay, okay, we'll remember, thank you Dr. Zhou." The man nodded quickly, helping the woman who was still wiping away tears.

Their family members treated Li Degang and Wang Jianming poorly, but treated Zhou Cheng very well. They remembered that it was Zhou Cheng who had just saved their daughter.

Zhou Cheng led Chen Xi and Li Yang out of the emergency room. As soon as they reached the corridor, he said to them, "Compile the medical history we just asked into the progress notes and integrate it with what the family said before."

"Based on the physical examination and medical history we just reviewed, could you analyze what other areas require further investigation besides the delirium and psychological issues we've already considered? For example, could it be a latent cardiovascular disease or an endocrine problem?"

"Okay!" the two replied in unison.

Back to the doctor's office.

At present, the top priority is to complete the examinations according to the consultation opinions. After all, the neurologists, cardiologists and ICU doctors have mentioned that the cause of the disease is unknown and that it is necessary to further investigate other system problems. This step cannot be skipped.

Zhou Cheng composed himself and said to Chen Xi and Li Yang again, "Based on the previous consultations from various departments, the patient's cause of illness is currently unknown, and the existing examinations alone cannot rule out all potential problems. The neurology department mentioned the need to investigate delirium induced by organic lesions, and the cardiology department has not found a clear cause for cardiac arrest, so further examinations are necessary."

Chen Xi and Li Yang immediately looked up, their eyes fixed intently on Zhou Cheng.

Zhou Cheng continued, "First, we arranged for the patient to undergo a cranial MRI. Compared to the previous CT scan, MRI can show subtle lesions in the brain more clearly and can further rule out problems that are difficult to detect on CT, such as microbleeds and demyelinating lesions. This is crucial for the neurology department to investigate the cause of the disease."

"Secondly, an electroencephalogram (EEG) is performed. If the patient has symptoms of visual hallucinations and confusion, it is necessary to rule out diseases related to abnormal electrical discharges in the nervous system, such as epilepsy. This is also an implicit direction of investigation during neurological consultations."

"In addition, we need to improve the blood tests related to rheumatology and immunology to rule out multi-system involvement caused by autoimmune diseases. This would respond to the previous suggestion from various departments to 'investigate other system problems'."

The two quickly jotted down notes in their notebooks, and Li Yang couldn't help but ask, "Professor Zhou, why do we need to do a second cranial MRI now? Didn't the previous head CT scan show no abnormalities?"

Zhou Cheng patiently explained: "CT scans are sensitive to hemorrhage and obvious space-occupying lesions, but they are not clear about some subtle structural lesions or metabolic abnormalities. The patient has an abnormal mental state and a history of cardiac arrest, so we cannot completely rule out organic brain problems based on CT alone. MRI can make up for the shortcomings of CT, making the screening more comprehensive. This is also to be responsible to the patient and avoid missing key causes."

After explaining, Zhou Cheng turned and walked towards the nurses' station, where he ran into Lin Ling, the nurse in charge of the patient.

He instructed directly, "Lin Ling, schedule a cranial MRI and EEG as soon as possible. Explain the situation to the department conducting the tests: this patient's condition is complex and the cause is unknown. Try to prioritize these tests to minimize waiting time."

"Okay, Dr. Zhou, I'll contact them right away!" Lin Ling nodded.

Recently, Zhou Cheng has become a prominent figure in the emergency department, and everyone talks about him during their leisure time.

Especially among Lin Ling and her group of unmarried nurses, everyone thought Zhou Chengren was a good person. He didn't have the bad habits of those older doctors. His biggest disadvantage was that he was just a probationary employee. If he could stay, he would definitely be everyone's ideal partner.

Zhou Cheng thought for a moment, then turned to Chen Xi and Li Yang and said, "Rheumatology and immunology related tests require blood tests. You two go to the ward later and talk to the family to explain the necessity of the tests, then get a test request form and have the nurse come and draw blood."

"Understood, senior brother!" The two nodded quickly and wrote the task down in their notebooks.