The Enhanced Doctor

"Brother Qiu, did you not watch what you ate at lunch?"

Old He was getting an MRI with his daughter, and Liu Banxia also started a conversation with Qiu Huaili.

"My goodness, what kind of nose do you have? I just had half a glass of beer to be sociable, and you could smell it?" Qiu Huaili asked helplessly.

"Well, my nose really does come in handy. Also, there's something I wanted to ask you: what are your thoughts on Ming Yuan wanting a dog?" Liu Banxia added.

"As long as it's as gentle as Tang Dou, that's fine. A bit of mischief or damage is alright; we can always buy new furniture. But it mustn't hurt Doudou. We'll see if Tang Dou's pups take after her. Don't tell me that boy is worried I might change my mind?" Qiu Huaili replied.

Liu Banxia quickly shook his head. "How could that be? I was thinking, if possible, we could consider a different one. I have a patient who has a Border Collie at home, but I haven't seen what it looks like yet."

Then Liu Banxia briefly described Lu Gang's situation, focusing, of course, on the Border Collie named Tiggie.

Actually, at first, he had wanted to ask Wang Mingxing, but then he thought better of it. Wang Mingxing wasn't busy right now, but what about the future? What would happen then?

Plus, he didn't know whether Wang Lishan would object to this, so he started to discuss it with Qiu Huaili.

"I don't mind. What does a Border Collie look like? They seem pretty obedient. I might take a look when I get the chance. As long as it doesn't often snarl or bite people, nothing else is really an issue," Qiu Huaili said after some thought.

"A Border Collie has a black and white forehead, with a white stripe down the middle," Liu Banxia said with a smile.

"But for now, I just wanted to give you a heads-up. Don't mention it to Ming Yuan yet, so he doesn't get his hopes up. If my patient is lucky, this round of chemotherapy could be very effective."

"You... I don't even know what to say. You could just stick to treating patients, but you insist on taking on everything yourself," Qiu Huaili said helplessly.

"Now that Old He isn't here, you're telling me all this. Do you have some ideas of your own? Don't try to fool me; I know you well enough."

"I have a rough guess; it definitely has something to do with the brain. Diabetes insipidus is often due to an excess of diuretic hormones in the body, which then makes it difficult to retain urine," Liu Banxia said.

"But whether it's currently due to pressure from a tumor, or caused by some other reason, I'm not quite sure. We should know once the brain MRI results are out."

"Still holding out on me? Then why did you also have her get a CT scan of her jaw?" Qiu Huaili glanced at him.

"I noticed her teeth were somewhat loose. Combining that with her symptoms of diabetes insipidus, I had a bit of a long-shot guess—a rare disease called Hand-Schüller-Christian syndrome," Liu Banxia said.

"But this rare disease usually affects young children. Let's see what the condition of her jawbone is. If it shows osteolytic lesions, then it's very likely."

"Does it also have anything to do with whether the kid has had eye problems?" Qiu Huaili asked curiously.

Liu Banxia nodded. "That's another symptom. However, this disease is very rare, and the age of onset is very young, typically around four years old."

"Come wait with me in the lobby. This room still needs to be used for seeing patients. Even though you're a big boss, when you're on my turf, you have to listen to me."

The afternoon crowd in the Emergency Department had increased. Although he could chat with Qiu Huaili, he couldn't just occupy a consultation room without using it.

Results from the blood tests, electrolyte tests, and urine tests came back the fastest, and everything was normal. Seeing these normal results, Liu Banxia's brow furrowed.

His initial thought was just a bold speculation, but now it seemed this little girl's illness was aligning with his guess. If there had been abnormalities in these test results, they could have followed those leads.

Seeing Liu Banxia frown, Qiu Huaili sighed. His friend's daughter's condition seemed to be rather tricky.

He knew Liu Banxia's character—he wouldn't pretend to be profound or put on a show. He couldn't understand these reports, but Liu Banxia's frown clearly indicated he was worried about the girl.

「A little while later」

Wu Bo called.

"Brother Wu, sorry to trouble you," Liu Banxia said as soon as he answered the call.

"Why be so polite with me? The films will take a little longer to come out. But the results aren't good. There are signs of rarefaction in the white matter of both cerebellar hemispheres, which could likely affect the child's development in the future," Wu Bo reported.

"Thank you, Brother Wu. She still needs to get a CT scan, though. Once it's done, you can just send me a message," Liu Banxia said.

"Alright," Wu Bo replied and hung up.

"Brother, what's the situation? Is it bad?" Qiu Huaili asked urgently.

"The child has rarefaction of the white matter in her cerebellum, which is currently affecting her motor function. As for other effects, we'll have to wait for the neurology department to conduct a more detailed assessment and treatment," Liu Banxia explained.

"The cerebellum manages the body's movement and coordination. The primary symptoms are ataxia and speech impairment. However, I think the child's speech and intelligence seem fine for now, but her movements are already affected."

"That's awful. Isn't this similar to cerebellar atrophy in the elderly? Ming Yuan's grandmother had cerebellar atrophy when she was old," Qiu Huaili said.

"It's pretty much like that. After they finish their tests, I'll have to call over the director of neurology for a consultation. I'll speak with them first," Liu Banxia said.

The director of neurology, Miao Yuqiang, didn't object when he received Liu Banxia's call and listened to his brief introduction. However, he was currently seeing a patient, so they scheduled the consultation for an hour later, by which time the CT scan should also be done.

The waiting was somewhat agonizing. When Liu Banxia received the text message and saw the CT scan results, he sighed inwardly. Just as he'd feared, the child's upper and lower jaw bones showed mild signs of resorption, which was the reason for her loose teeth.

After pondering for a moment, Liu Banxia also arranged an eye examination. Old He and his wife hadn't noticed any issues with the child's eyes, but an examination with modern instruments could detect it.

"Liu, are the child's CT scan results in?" Miao Yuqiang came over.

"Director Miao, the results for the brain MRI and jawbone CT are out. Please take a look. I suspect the child has Hand-Schüller-Christian syndrome. I also had her eyes examined, and those results should be back soon," Liu Banxia said quickly.

Miao Yuqiang looked at him, nodded, and then began to review the scan results.

"During the examination, I also noticed that the child is excessively thirsty. She had to go to the toilet less than eight minutes after drinking three glasses of water," Liu Banxia continued.

"Have the blood tests and electrolytes been done as well?" Miao Yuqiang asked.

Liu Banxia quickly passed over the other test reports.

Looking at the data on them, Miao Yuqiang also frowned. This was quite tricky.

"Although we haven't done a detailed examination yet, your guess probably isn't wrong. However, we still need to do further tests to see if it's due to damage to the neurohypophysis, which secretes antidiuretic hormone. Sigh... that's likely correct as well," Miao Yuqiang also sighed.

At this moment, Old He, his daughter, and Qiu Mingyuan returned. The result of the eye test showed coarse nystagmus in both eyes, both vertically and horizontally.

"Liu, you're more acquainted with them. You explain it to the family," Miao Yuqiang said after reviewing the results.

"Ming Yuan, take the child to buy some snacks," Liu Banxia said, sending the child away.

"Brother He, although we haven't done more detailed tests yet, we can determine that your daughter has Hand-Schüller-Christian syndrome."

"The primary symptoms of this disease are diabetes insipidus, bone lesions, and diffuse cerebellar lesions. The child's diabetes insipidus is actually secondary in her case. It's most likely that her body produces insufficient amounts of a substance called antidiuretic hormone, and that's why she has diabetes insipidus."

"Dr. Liu, so can't we just supplement what she's lacking? Even if we have to sell everything we own, I have to cure my child," Old He said anxiously.

"Brother He, I haven't finished yet," Liu Banxia said with a bitter smile.

"At present, the symptoms aren't very severe, meaning the impact on the child is relatively small. Hand-Schüller-Christian syndrome currently has no consistently effective, stable treatment."

"Let's put it this way: the child's diabetes insipidus causes her to drink a large amount of water. In a way, this response is a form of self-protection for her body. Our bodies contain various chemical components, such as sodium, potassium, and iron—these trace elements."

"Under normal circumstances, if ordinary people drink that much water, it would definitely lead to the loss of trace elements and cause hyponatremia and hypokalemia. But look at our child's electrolyte test report; they are all normal."

"Our child started drinking water because of diabetes insipidus, not the other way around. With diabetes insipidus, her body expels mostly dilute urine, meaning many sodium ions aren't excreted with the water. This leads to an excess of salt in her body, which is why she's thirsty and needs to drink."

"We can use medication to manage antidiuretic hormone levels, but if we do so, we would need to carefully control the child's water intake. And this monitoring needs to be very precise."

"Because if the child drinks too much water while on such medication, as I mentioned, she will develop hyponatremia and hypokalemia, endangering her life. The excessive water intake would have diluted the concentrations of sodium and potassium ions in her body."

"To put it simply, that line of treatment is possible, but we would have to control her water intake strictly. Her daily water intake and output must be carefully monitored. Otherwise, the child's life could be at risk. In a sense, forgoing this particular line of treatment might actually be the best course of action. At worst, she'll just continue to drink a bit more water and go to the toilet more often. Director Miao, is my explanation clear?"

Miao Yuqiang nodded. "That feeling of intense thirst... not just children, even we adults would find it hard to resist."

The people around were all stunned. This was the first time they had heard of such a disease.

If it weren't for Liu Banxia's detailed explanation and Director Miao's confirmation, they would have thought they were being fooled.