[Medical Human Story – Episode 73]-Prologue: Before Dawn That Morning, I Came Face-to-Face with Someone's Future
[MHS: Medical Human Story]-Episode 73
Prologue: Before Dawn That
Morning, I Came Face-to-Face with Someone's Future
I have interpreted thousands
upon thousands of CT and MRI scans.
Some people say that
radiologists never actually meet their patients.
But they do not understand.
Within a single medical image
lies the story of an entire human life.
The black-and-white shades on
a monitor are not merely pixels.
They are a mother's tears,
a husband's anxious waiting,
a child's silent prayers,
and a patient's final hope.
As always, I arrived at the
hospital before five o'clock that morning.
The corridors were as quiet as
ever.
The coffee in the on-call room
smelled burnt,
and in the emergency
department, the boundary between night and day had long since disappeared.
A hospital is a place where
time seems to stand still.
Someone is born.
Someone survives.
Someone takes their final
breath.
And we are the people who
witness every one of those moments.
My name is
Dr. Elias Lee.
I am a medical content
specialist
and a physician deeply devoted
to the field of radiology.
I have always believed
that a truly good doctor is
not merely someone who treats disease,
but someone who never stops
searching for hope until the very end.
Yet on that particular day,
even that belief began to
waver.
"Doctor, Please Look at
the CT Scan First."
An emergency medicine resident
rushed toward me.
He was out of breath.
"A 50-year-old
woman."
"She developed a sudden,
severe headache."
"Her blood pressure is
over 220."
"She's been vomiting
repeatedly..."
"...and just a few
minutes ago, her speech became noticeably slow."
I looked into his face.
He was an experienced
resident.
Yet there was something in his
eyes—
an uneasiness that was
difficult to explain.
"Was it a thunderclap
headache?"
At my question,
he slowly nodded.
"Yes."
"This is exactly how the
patient described it."
"It felt like a bomb
exploded inside my head."
That single sentence was
enough.
Instantly,
dozens of differential
diagnoses began forming in my mind.
Subarachnoid hemorrhage.
A ruptured cerebral aneurysm.
Reversible cerebral
vasoconstriction syndrome.
Hypertensive intracerebral
hemorrhage.
Cerebral venous sinus
thrombosis.
And...
one rare but critically
important diagnosis that must never be overlooked—
Posterior Reversible
Encephalopathy Syndrome (PRES).
The Emergency CT Images
Appeared on the Screen
The monitor came to life.
Hundreds of axial CT slices.
I slowly scrolled through them
with my mouse.
The first image.
The second.
The third.
...
And then—
my hand stopped.
"..."
The occipital lobes.
Both sides.
Almost perfectly symmetrical.
Along the white matter,
subtle areas of low
attenuation were spreading.
At that very moment,
another finding caught my eye.
Hyperdensity.
Within the subarachnoid space.
Hemorrhage.
I drew a slow breath.
"No way..."
This patient
did not simply have a typical
subarachnoid hemorrhage.
The location of the bleeding
was unusual.
It was not within the basal
cisterns,
where ruptured aneurysms most
commonly bleed.
Instead,
it involved the posterior
cerebral convexities—
the occipital region
and the parietal cortex.
Convexity subarachnoid
hemorrhage (Convexity SAH).
Keeping my eyes fixed on the
monitor,
I spoke quietly.
"This could be
PRES."
[Insert Figure]
The Patient's Husband
The door slowly opened.
A man walked into the room.
His hands were trembling.
"My wife..."
"...is she going to
die?"
It is the most difficult
question anyone can ask inside a hospital.
We cannot lie.
Yet we must never abandon
hope.
I remained silent for a
moment.
Then I gently offered him a
chair.
"We don't know yet."
"But..."
"It's not too late."
His voice broke as he
struggled to continue.
"She was perfectly fine
this morning."
"She made breakfast for
the children..."
"She was getting ready
for work..."
"...and then she suddenly
grabbed her head..."
"...begging someone to
save her..."
He could say no more.
I looked quietly at his
slumped shoulders.
An illness is never suffered
by only one person.
When one member of a family
becomes ill,
the entire family carries the
pain together.
The Emergency MRI
Thirty minutes later,
the MRI examination began.
FLAIR.
DWI.
ADC.
GRE.
These were the images I had
been waiting for.
On the FLAIR sequence,
the occipital lobes appeared
strikingly hyperintense.
But the diffusion images told
a different story.
There was no diffusion
restriction on DWI.
The ADC values were, in fact, increased.
I let out a quiet sigh of
relief.
"This is vasogenic
edema."
"There is still..."
"...a chance to reverse
it."
[Insert Figure]
[Medical Insight]
I Looked Into the Patient's
Eyes
She had not yet lost
consciousness completely.
Slowly,
she opened her eyes.
In a faint voice,
she whispered,
"Doctor..."
"...will..."
"...I survive?"
Whenever I hear that question,
my heart always responds the
same way.
A physician
cannot promise life.
But we can promise
that we will never stop
fighting for it.
I gently took her hand.
"Let's find our way back
together."
"Back to your everyday
life."
"Back to your
family."
"Back to your
tomorrow."
A single tear
formed at the corner of her
eye.
I hoped
that it was not a tear of
fear,
but one of hope.
[Medical Recommendation]
Next Chapter ☞Part I: The Strom Arrived Without a Single Warning
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