The Enhanced Doctor

(Thanks to good friends Yuan Qiuyan, Yuan Mie, and Yuan Ziyuan for their rewards and monthly ticket encouragement)

"This disease is an autosomal dominant genetic disorder," Liu Banxia said after opening all the take-out boxes. "What this means is that if one of you carries this genetic condition, your children have a 50% chance of inheriting it."

"But, neither my wife nor I have ever experienced symptoms like our child's. At least I know that the color of my urine isn't unusual," the child's father said.

"This disease can also be triggered under certain conditions. Some people may have attacks induced by certain drugs such as barbiturates, sulfonamides, Aminopyrine, and corticosteroids. Others, like your child, develop it due to intrinsic factors."

"Your child is usually a picky eater, but he used to eat whatever he liked until he was full, so his body absorbed plenty of calories. When his diet changed to primarily greens, which he dislikes, he ate less. Consequently, his body's stored energy decreased, which likely triggered the disease."

"The external manifestations of this disease can vary greatly. Your child's case is very mild; it was only after this prolonged episode that he finally developed photosensitivity."

"Actually, in folk parlance, this disease is also known as porphyria. Exposure to sunlight can cause skin burns. Of course, this occurs at a very severe stage of the disease."

"Doctor..., is there... is there a chance to completely cure this disease?" The child's father asked, clutching his chopsticks, unable to eat a single bite.

"At the moment, there is no cure for this disease since it's genetic. We can only try to prevent flare-ups and manage the symptoms," Liu Banxia remarked after some thought.

"So, when you get the chance, both you and your wife should get checked at the hospital to identify which one of you carries this disease."

"Rest assured, as long as you pay attention to your daily habits, it should not disrupt your normal life. Neither you nor your wife have shown any particular symptoms up to now, right?"

"However, there are many things you need to be attentive to. Let the child eat his fill first and regain some strength, then I'll find a specialist who can help you understand what is happening."

"Doctor, what is the risk level going forward for our child?" the father asked, looking at him.

"That's hard to say. If managed well and all precautions are taken, there should be no problems," Liu Banxia replied after some thought.

"The typical onset period for this disease is between the ages of 20 and 40. If it flares up then, the impact on the patient can be quite significant. Since your child is showing symptoms now, at least we can begin to take preventive and control measures."

"One thing I always say to my patients is that getting diagnosed with a disease isn't scary. What's scary is discovering it too late. In this case, we've detected it quite early, so we can prepare for it."

"Emotional support is also crucial. Especially once the child is old enough to understand, how this is explained to him will require careful consideration."

Having said that, Liu Banxia lowered his head and started eating his meal. He had already explained all that he could; more specialized advice would require a specialist's explanation.

He could indeed diagnose the disease, but adjusting and controlling it wasn't his job. It's like recognizing many words when you see them, but being unable to write them when asked.

He wasn't a specialist in this area. This wasn't a condition that could be fixed by simply cutting something out of the body.

After they finished their meal, although the child didn't immediately return to normal and still showed slight photosensitivity, his abdominal pain had completely resolved. A repeat urine test showed indicators similar to the first test.

The only person he could recommend was Assistant Director Xiao He. As for who should be invited for a consultation next, or whether they should go to a hospital specializing in this genetic disorder for further diagnosis, was no longer his concern.

"Brother Xu, today was so dangerous; it was a close shave. Even though the initial urine test showed slightly elevated porphobilinogen levels, I didn't give it much thought," Liu Banxia said.

"I would have done the same. Anyone who drinks less water might show increased porphobilinogen levels. It was only a tiny bit higher; who could have anticipated that?" Xu Hui replied with a laugh.

"Actually, this disease isn't that rare these days. I remember the city hospital also diagnosed a case recently. And the onset of this child's symptoms is rather unusual; it's uncommon for the disease to manifest at seven years of age."

"We regret not waiting here instead of going for a meal," Liang Xiaolin, who overheard the conversation, murmured.

"What has this got to do with you? You're a cardiac surgeon, why are you getting involved?" Liu Banxia said helplessly.

"Why not? The process of exploration is also the process of learning," Liang Xiaolin retorted, unconvinced.

"I suppose you're right… Hmm, what's this group doing here?" Liu Banxia said, halfway through his sentence, then turned his gaze towards the entrance of the waiting hall.

More than ten people entered. It appeared to be parents accompanying their children for treatment. However, seeing such a large group arrive together was rare.

If it weren't for the few parents among them, Liu Banxia would have thought they were here to cause trouble. However, these young people didn't seem to be in good condition. Had they been collectively poisoned? That would be a major incident.

"Teacher Liu, these patients and their families are here to see you," Li Hao, who was responsible for triage, called out.

"Hello everyone, I'm Liu Banxia. What seems to be the problem?" Liu Banxia asked.

"Doctor, please examine our children too. Their hands and feet are numb and unresponsive. Lingling came to you last time, and she has improved a lot," one of the parents said.

"Lingling?" Liu Banxia frowned; he had no recollection.

"Nitrous oxide," Liang Xiaolin reminded him from the side.

Liu Banxia finally recalled. He glanced at the six young people and sighed inwardly.

They were undoubtedly the friends who often hung out with that girl. It's just that her symptoms appeared quickly, and she sought timely medical attention, so her treatment was relatively easier.

Now, among these people, two had arrived in wheelchairs. It was hard to say whether their nerves had suffered permanent damage.

"I understand everyone's situation," Liu Banxia said. "However, for symptoms like these, our emergency department needs to run some initial investigations. The previous patient was also referred to the Neurology Department, where they formulated a specific treatment plan."

"Everyone, please wait a moment. I'll contact the Neurology Department to see if Director Miao is available. Then I'll take you all there to be seen together."

He could only handle it this way; otherwise, these people would have to repeat the examinations upon arrival at the Neurology Department. Besides, it would be challenging for just one attending neurologist to handle so many patients.

He contacted the Neurology Department and got lucky. It wasn't afternoon office hours yet, so Director Miao was resting. Liu Banxia could take advantage of this window to bring these people over.

"There are quite a few patients, so I'll personally go over. You all stay alert here, and call me if anything happens," Liu Banxia instructed.

Liang Xiaolin and the others looked at him eagerly; they actually wanted to follow and see what was happening, but Liu Banxia hadn't invited them.

"You all can come too; it will be beneficial for your future clinical work," Shi Lei, who had just arrived for his shift, said.

Then the group all looked in unison at Liu Banxia.

What could Liu Banxia say? With a wave of his hand, the large contingent set off.

"Director Miao, these are friends of the patient who inhaled nitrous oxide, the one we transferred from the ER previously. The cause of their symptoms is the same; they all have a history of nitrous oxide use," Liu Banxia said after they arrived at Miao Yuqiang's office.

"Peng Bo, first give these patients a brief physical examination, then order blood tests and schedule MRIs," Miao Yuqiang said after glancing around the room.

"You lot, don't just stand there watching. Assist Doctor Peng and gain some experience," Liu Banxia also spoke, instructing the interns he had brought with him.

Even though they often performed these tasks in the emergency department, they found it a novel experience in the Neurology Department.

"You rascal, you never miss a chance for them to learn," Miao Yuqiang said. "However, this matter needs to be reported to the higher authorities. Prepare a report later; I won't bother with it."

"Director Miao, are there many patients who have used nitrous oxide?" Liu Banxia asked in surprise.

If it were just these few, even though it seems like a lot, it wouldn't reach the threshold for reporting. A report is only required if the condition becomes prominent, there are many potential patients, or it's linked to a major event.

For example, infectious diseases or mass food poisoning incidents must be reported. But for nitrous oxide, unless the scale is large, there are no other grounds for mandatory reporting.

"After attending to the previous patient, I contacted the First Hospital and the City Hospital," Miao Yuqiang said. "Although they had no cases at that time, patients have sought treatment sporadically since then: two at the First Hospital and three at the City Hospital."

"At first, I thought these cases were related to our patient. But now it seems this is a different group. This indicates that while nitrous oxide use may not be rampant in Binhai City, its distribution channels are numerous and widespread."

"Director Miao, thank you for giving me the credit," Liu Banxia said gratefully.

"It would be no use for me to take it. Besides, the first patient of this kind in Binhai City was handled by you, and you made the correct diagnosis at the time, so you should also handle the concluding matters," Miao Yuqiang said with a laugh.

"Prepare it well; make it comprehensive. You don't need to include personal opinions or views, just focus on the severity of this situation."

Liu Banxia scratched his head in embarrassment. "I'm truly lucky to have so many people caring for and guiding me."

"Don't feel burdened, or else Director Zhou would ridicule me endlessly. You go back to your work; I'll send your interns back after their check-ups are done," Miao Yuqiang said.

"Director Miao, thank you for your help," Liu Banxia replied quickly.

As Liu Banxia walked out, he was deeply moved. Have I truly earned the hospital's recognition? I don't even have a personal connection with Miao Yuqiang, yet he's practically forcing this credit on me.