The Returning Doctor Wanted to Live Quietly - Chapter 380



Only Noblemtl

Episode 380. Doctor Jang’s identity (2)

Tourette syndrome.

It is mainly caused by genetic factors.

If someone in your immediate family has tics, your chances are 25%.

If they were identical twins, the rate was close to 90%.

But there is no genetic predisposition.

Jinhyuk spoke softly.

“First of all, it’s not genetic… … .”

“There is a possibility that the guardian lied.”

“The child is acting strangely right now. I don’t think he’s lying.”

“Then could it be a bacterial infection?”

“The causative agent has not been identified. It’s written on the chart.”

“That’s right.”

After a brief conversation.

Jinhyeok and Jang Hyukjun looked at the chart again.

The other doctors who were watching this just waited quietly.

They are surgeons anyway.

I brought it here because there are some people who are skeptical.

As for his skills, they have already been confirmed in the operating room.

Because they are amazing doctors who finished the surgery two hours earlier than the expected end time.

So, looking at the chart again.

Jang Hyuk-jun casted the Jeon-eum-ip-mil spell.

“I don’t know?”

“I don’t know.”

“Oh, so it’s ruined?”

“So who says, ‘Let’s go’ there? When exchanging emails, there is at least time to review them. There is no such thing here.”

“Oh, I don’t know. I don’t know.”

Jang Hyuk-jun, who was quickly speaking Korean like a reclusive master from a martial arts novel, had a calm expression on his face.

And then.

“I would like to meet the guardian first.”

He calmly called his guardian.

* * *

The whiter the skin, the more sensitive it is to UV rays.

At the request for cooperation.

The face of the guardian standing at a distance was covered in freckles.

She seemed like a typical white woman, nothing more, nothing less.

What’s unusual is that the husband is holding a boy who looks younger than the pediatric patient.

Jang Hyuk-jun started asking them questions.

The problem is.

“What are these people?”

“This is not what I wanted. You asked for a consultation, but all you called was an Asian doctor?”

This is the reaction that came back.

The expression on his face was clearly one of disdain for the Asian doctor.

So much so that even a non-idiot can feel it.

But the explanation followed immediately.

Dr. Lee is also famous as a genius in Korea, but Dr. Jang is said to be a true genius who has solved numerous difficult problems.

It even led to the saying that there is no need to go through hardship when it is easy to go.

Jang Hyuk-jun immediately coughed in vain.

“Ugh, big. It’s like I misplaced a comma and now my wife is giving me a bill… … .”

If the cause could not be found, there would be no shame like this.

* * *

“You never gave me stress?”

“Of course not. Could there be any?”

“Yes. He’s not even three years old yet.”

“… … .”

“Then what are the factors that can cause infection… … .”

“There’s no way that could happen.”

“What about Kindergarten? My child is still young, so I think he will go to kindergarten.”

“Everyone is fine except for our child.”

It wasn’t a sudden change in behavior due to stress either.

That means it’s not an environmental factor like infection.

Because the symptoms appeared just the day before.

It was also not brain damage that might have occurred during birth.

hereto.

“It’s not a bacterial infection caused by group living. It’s not an abnormal immune response. Hmm… … .”

Jang Hyuk-jun, who had made his own definition, began to manage his facial expressions.

At first glance, it may seem like he is trying to keep his composure while calming the parents of a sick child.

Jang Hyuk-jun explained again for a long time.

Originally, impressions weren’t easy.

It is especially difficult for pediatric patients.

of course.

“Oh, I feel like I’m X right now. Please do something about it quickly.”

It goes without saying that he also used the secret method of transmission towards Jinhyeok.

* * *

That moment.

Jinhyuk also tried to look calm, but his head was spinning.

As with all things, the ending must be good.

The saying that the last beauty is the best has been around for thousands of years for a reason.

I thought that if I went back like this, I would have neither food nor shelter.

Because I said there are still some people who are half in doubt.

No, more than anything, I was worried that my child was sick.

A child not even 36 months old.

I wasn’t in a position to be lying in the hospital like this.

The cause had to be found out immediately and appropriate treatment had to be administered.

so.

‘I think it’s Tourette Syndrome. But the exact cause hasn’t been identified anyway… ‘

Jinhyuk tried to change his thinking.

Tourette syndrome can occur for a variety of reasons.

Not all causes have been identified by humans.

So, I decided to skip looking for the cause and focus on reconfirming the given phenomenon.

“Let’s do it the right way.”

“Should we go the regular way?”

“Yes, let’s start with a stethoscope.”

“Okay, then.”

Jang Hyuk-jun belatedly received a stethoscope and attempted to perform auscultation.

There was no upper respiratory infection, and lung sounds were very clear.

The child’s kicking became more intense, but I ignored it and listened to the heartbeat.

Then I immediately checked the vital signs.

Blood pressure is 60 over 100.

Heart rate is 92 beats/minute.

Respiratory rate: 28 breaths/minute.

Body temperature is normal at 36.2 degrees.

Everything was normal except for the strange behavior.

Jang Hyuk-jun, who checked his vitals once again, tried to stimulate them this time.

It was Jinhyuk’s job to catch the child who was making strange noises and moving his body at will again.

Jang Hyuk-jun, who had been touching here and there for a while, tried to penetrate the sound again.

“My legs are normal. My arms are fine.”

“Are you saying everything is normal?”

“No, there’s just one thing that’s weird.”

“What’s strange?”

“Neck stiffness. Your neck muscles are abnormally contracted. Let me do a quick test.”

Without even hearing Jinhyeok’s answer.

Jang Hyuk-jun spoke to the child.

Turn your neck to the side and look.

It also tells us to lean forward again.

But it doesn’t budge.

As if I didn’t understand.

In addition to that.

Taaak.

Percussion.

Knock knock.

When he moved his jaw joint again, made a strange noise, and even kicked, Jang Hyuk-jun took a step back.

* * *

Cervical dystonia.

So-called cervical muscle tension disorder.

Since it wasn’t written on the chart, it could be assumed that the symptoms had just begun to manifest.

Jang Hyuk-jun, who explained this, gave instructions again.

“Let’s start with a cervical CT scan. Oh, and I think it would be good to get a brain CT scan as well.”

A statement that nerve damage is suspected.

Eventually, I had a CT scan of my head following the cervical CT.

Some people are terrified of exposing their children to radiation.

This is a must do.

As long as I wasn’t getting CT scans every day, it wasn’t too bad.

The problem was that Jang Hyuk-jun was able to determine the size of the hematoma using only X-ray images.

That means you waited without asking for a reading.

Jang Hyuk-jun, who had to watch the video himself while crying, tried to enter the theater again.

“It looks normal. Unlike the video, my muscles are really completely bunched up… … . They’re not twisted. They don’t look overly swollen or anything.”

“There is no difference in muscle density at all.”

“Yes, of course there are no degenerative changes.”

“Well, that’s to be expected since he’s still young.”

“It doesn’t seem like the nerves have been compressed abnormally for a long period of time… … .”

“First, let’s look at the brain CT image.”

I should have gotten an MRI or MRA, but it was only natural to get a brain CT first.

The problem was that nothing unusual was seen on brain CT scans.

What followed was a brain MRI.

This was also fine.

Even though I had an EEG, the waveform was normal.

A situation that cannot be dismissed as epilepsy!

hereto.

“It could be an infectious disease like meningitis, so let’s do a lumbar puncture.”

Jang Hyuk-jun once again expressed his opinion with a calm expression.

* * *

The crowd of onlookers became a little confused.

As if I had taken the time to observe.

It changes as I go to do my work, or come home from work, or come back and hear the news.

Regardless of them.

“You stabbed with such a big needle?”

If the guardian’s reaction was the problem, then it was a problem.

To check for infectious diseases, cerebrospinal fluid had to be drawn and checked.

I am reluctant to insert a long needle to drain my spinal fluid right away.

So, I persuaded Jang Hyuk-jun’s guardian for a while.

This means that it is possible to measure brain pressure and check the shape of cerebrospinal fluid.

Measures the amount of glucose, protein, white blood cells, etc. in the cerebrospinal fluid.

He said that through this, it is possible to culture microorganisms and conduct morphological examinations of cells.

The recommendation was made after much persuasion.

Still making weird noises.

The child whose behavior was even more violent was tied up first.

Then, we immediately begin the preliminary work to make a recommendation.

Simply administer a sedative.

Disinfect the puncture site immediately.

In addition, local anesthesia is administered.

Between the fourth and fifth lumbar vertebrae, i.e. above the inner iliac crest.

Accordingly, the cerebrospinal fluid comes out as the dura is punctured.

Jang Hyuk-jun’s action of discarding the first three drops and then waiting without applying any pressure to the syringe was textbook-like.

The history of having rolled around countless times in hospitals you know is clearly revealed.

The problem is.

“Why is this normal again… … .”

The cerebrospinal fluid test results also came back normal.

* * *

One step back to take one step forward.

I came to the bathroom.

Both at the same time.

Then, Jang Hyuk-jun immediately started to cry.

“Comrade Ramen, what do we do now?”

“well.”

“If it’s a bacterial infection, the protein level should be high and the glucose level should be low.”

“Your glucose level is low. It came out to 56 mg/dL.”

“But it’s within the normal range. The protein should be that high, but it’s not.”

Both of them were silent for a while.

First of all, it has been confirmed that it is not a bacterial infection.

Tourette’s disorder due to non-infectious causes.

The cause of this too was not guessed.

“Don’t worry about us now. You should worry about your sick child.”

“I’m saying this because I’m worried about the patient too.”

“Is it true?”

“Of course. Ah, you think I’m only worried about myself right now.”

“… … .”

“Oh, this is really a big deal.”

Jang Hyuk-jun cried for a while and then walked outside.

In fact, it was a very confusing situation.

There are clear, visible results, all numbers are normal.

Even white blood cells and red blood cells were not detected in the cerebrospinal fluid.

So on the way back again.

Jang Hyuk-jun suddenly stopped walking.

And then.

“Hey, what’s that?”

Refers to a guardian who is soothing a child.

A struggling child.

He was moving his jaw joints haphazardly and even making animal sounds like his older sister.

If it were just one person, I wouldn’t know.

If there are two people, the situation is different.

The probability of showing the same symptoms.

There was only one chance that the symptoms would occur back-to-back, yesterday and today.

* * *

It would have been nice to have a proud expression, but Jang Hyuk-jun controlled his expression.

It’s a situation where I can guess what’s going on.

He took off his glasses again with a calm expression.

When he, wearing fashion glasses, coughed in vain, everyone’s attention turned to him.

Jang Hyuk-jun slightly pushed up his glasses and turned towards his guardian.