"Why do you look so happy? I thought you were heading to the medical department for a fight or something," joked Liang Xiaolin as Liu Banxia returned to the emergency department.
"What would I fight about?" Liu Banxia said with a smile. "I wasn’t even received by their department head, just a staffer. I simply presented the facts and reasoned with them. The core idea is that we can’t be soft-hearted. Being a doctor is already difficult enough; we must advocate for doctors." Thᴇ link to the origɪn of this information rᴇsts ɪn 𝕟𝕠𝕧𝕖𝕝⁂𝕗𝕚𝕣𝕖⁂𝕟𝕖𝕥
"Do you need some applause?" Liang Xiaolin asked teasingly.
The interns nearby couldn’t help but laugh. Among those at the intern level in the emergency department, only Liang Xiaolin dared to joke with Liu Banxia like that; others didn’t have the nerve.
"Actually, thinking about it makes me a bit sad," Liu Banxia said, lowering his head.
"What’s wrong?" Liang Xiaolin asked curiously.
"We’re moving to the new building on the ninth, and then you’ll be off mixing with the thoracic surgery folks," Liu Banxia said, lowering his head again and pinching the bridge of his nose.
Liang Xiaolin frowned. She instinctively felt this guy was up to something mischievous. What’s wrong with going to thoracic surgery? Isn’t she still part of the emergency department? They’d still be working together.
"It’s like raising a daughter only to marry her off to another family," Liu Banxia added.
This infuriated Liang Xiaolin. He’s the chief resident, and he dares say something like that? I’d beat him up without a second thought! This is intolerable!
"Dr. Liu, do we need to prepare a dowry for Doctor Liang?" Qing Kewa asked cheerfully, clearly enjoying the situation.
"Qing Kewa, why are you joining in his nonsense? This is so frustrating," Liang Xiaolin said, giving her a helpless look.
"Don’t you need to prepare a dowry when someone gets married?" Qing Kewa asked, feigning confusion.
Liang Xiaolin gave up. Trying to explain this to Qing Kewa was a lost cause.
"Alright, Banxia, prepare to receive a patient," Wang Ying said, walking over. "A child had a seizure at an event in the National Exhibition Center and is being sent to us. Apparently, they have a history of epilepsy for about two years."
"Okay. Wang Chao, prepare for admission," Liu Banxia said.
Although he hadn’t seen the patient yet, based on such a long history of epilepsy, he judged it was likely idiopathic epilepsy. This type is common in adolescence, isn’t related to cranial nerve issues, and presents only with epileptic symptoms. As long as the seizures don’t cause self-harm, these conditions are generally untreatable. This is typical for many idiopathic diseases, as their root causes are often untraceable.
After about ten minutes, an ambulance pulled up before the entrance of the outpatient waiting hall. Two young girls in elaborate costumes, likely for a comic convention or a similar youth event, emerged from the vehicle with a gurney.
The patient on the gurney, also a young person wearing a wig, was chatting intermittently with their companions.
"Vital signs are normal. They had another seizure in the ambulance, lasting twenty-seven seconds," the paramedic reported.
Liu Banxia nodded. "No need for the resuscitation room. Just put her on an examination bed."
"Can you tell us about your history of epilepsy?" Wang Chao asked the patient.
"I’ve been checked at other hospitals," the patient said. "It’s idiopathic epilepsy. They said it would disappear as I get older."
"This time, it was probably because I was too tired; I’ve been preparing for this. Can you please not inform my parents? They don’t know what I’m doing now. Telling them would just make them worry for no reason, okay?"
Wang Chao glanced at Liu Banxia, who simply shrugged. It’s up to Wang Chao to decide; he’s the attending physician, after all.
"Let’s run some tests first," Wang Chao said. "Although it’s difficult to find the cause of idiopathic epilepsy, your seizures happened in very quick succession this time."
"As long as you don’t call my parents, that’s fine. Lan Lan, please go register me," the patient said to one of her companions.
The young woman nodded and left with the bag to handle the registration.
"Before the seizure, did you feel anything else? Or was there anything specific you saw that made you uncomfortable and then triggered it?" Wang Chao continued asking.
"I don’t think so," the patient said after a moment of thought. "It’s just that there were a lot of people around our booth today, and many people were taking pictures."
Wang Chao looked a bit troubled, unsure whether to order an EEG. He looked at Liu Banxia again.
Liu Banxia just shrugged, a faint smile on his face. This made Wang Chao quite uneasy; he always felt there was something hidden behind Liu Banxia’s smiles.
"Then let’s observe you for a few more hours. Are you experiencing any other abnormalities right now?" Wang Chao asked.
"I didn’t eat breakfast, and my heart feels a bit fluttery. Does that count as abnormal?" the patient asked.
"That probably doesn’t count. Let’s observe for a while. We’ll take your blood pressure and temperature. Wait..."
Before Wang Chao could finish, the patient’s eyes rolled back, and she had another seizure.
Everyone quickly sprang into action, turning the girl onto her side and ensuring her safety.
Liu Banxia frowned. How could idiopathic epilepsy cause seizures so frequently? This is the third one already. Could the other hospitals have misdiagnosed it?
"Connect the monitor! Two units of lorazepam!" Liu Banxia ordered quickly, seeing the seizure continue for two minutes with no signs of abating.
Liang Xiaolin and the others immediately got to work. The duration of this seizure was indeed quite long.
"Huh!" Liang Xiaolin exclaimed softly while attaching the electrode pads, though her hands didn’t stop.
"What’s wrong?" Wang Chao asked anxiously.
"Nothing, it’s almost connected," Liang Xiaolin replied quickly.
"Blood pressure is zero! Ventricular fibrillation! Uh... it’s back!" Liang Xiaolin called out as soon as the monitor was connected.
"Prepare for defibrillation! One milligram of epinephrine, get ready with 150 joules!" Liu Banxia calmly instructed.
Wang Chao and the others carefully laid the patient flat. Only then did they realize why Liang Xiaolin had exclaimed earlier. It turned out this wasn’t a young girl, but a young boy.
But no one had time to dwell on that; everyone was anxiously watching the numbers on the monitor.
"Alright, blood pressure and heart rate have recovered. Blood oxygen is at 86%. Administer oxygen. This seizure lasted three minutes and seventeen seconds. Contact the parents," Liu Banxia instructed.
The patient looked at him, appearing as though he wanted to object but lacked the strength.
"I suspect your epilepsy symptoms have changed," Liu Banxia said. "You need to be admitted for treatment. Normal idiopathic epilepsy wouldn’t cause such frequent seizures."
"Don’t worry. We’ll get you into a hospital gown shortly, and your friends can look after your belongings. If we don’t find out the cause, your next seizure could be just as dangerous."
The patient nodded; this episode had clearly exhausted him.
"We need a complete blood count, blood chemistry panel, EKG, and EEG," Liu Banxia added.
"President Liu, did you realize from the beginning?" Wang Chao asked, stepping to the side.
Liu Banxia nodded. "That’s why you need to be more observant during admissions. The Adam’s apple wasn’t prominent, but it was there if you looked closely."
"But the most worrying thing now is his condition. It’s unclear if ventricular fibrillation occurred during the seizure. There was a moment when both blood pressure and heart rate were zero."
*DING! Task issued: Patient with Idiopathic Epilepsy.*
*Open-ended task: As the host observed the monitor readings dropping to zero, there is a suspicion of misdiagnosis by other hospitals. Conduct necessary examinations to explore the condition. Task rewards will be issued based on examination results.*
"No way!" Wang Chao said. "He has a two-year history. If it were caused by something else, it should have worsened by now."
"That’s why I’m somewhat unsure," Liu Banxia said. "If ventricular fibrillation did occur, it’s highly possible the seizures are linked to a heart condition."
"I’ll see if any cardiologists are around. They know more about cardiac issues. If we don’t figure this out and he has another seizure outside the hospital, it could be really dangerous."
"You watch him. I’ll go contact them," Shi Lei said as he passed by.
At this point, the EKG results came back: all normal, no issues detected.
This was fairly common. While an EKG is crucial for diagnosing heart diseases, it’s often difficult to detect problems when the heart isn’t actively experiencing an event.
The EEG results were similar: everything normal.
"Doctor, since I’m okay now, can we not contact my family?" the patient asked Liu Banxia.
"Don’t worry, we’ll help you cover. However, your two companions here will need to adjust their appearance a bit, or it might look suspicious," Liu Banxia said with a smile.
"As I said, your seizures today were unusual. The second one was very short, but the third was very long. Under these circumstances, it would be irresponsible of us not to inform your parents. Since you’ve come to our hospital, we need to get a clear diagnosis before you can leave."
"Doctor, I had a lot of tests last year, at several hospitals. I even had an MRI and a lumbar puncture. You’re not going to do another lumbar puncture, are you?" the patient asked.
"For now, that likely won’t be necessary. My main suspicion is a problem with your heart," Liu Banxia explained.
"Try to recall: during your seizures, did you feel anything unusual in your heart? Like pain, or a racing heartbeat?"
The patient frowned, thinking hard. "No, no other feeling. I usually don’t know when it’s going to happen, and then it just... happens? I can’t remember clearly."
"It’s okay, don’t strain yourself trying to remember. Leave the rest to us doctors," Liu Banxia said comfortingly.
Epilepsy can range from minor to severe. Even if the patient only has typical epilepsy, it can greatly impact their life. At his age, he should be in school. Because of his condition, classmates might label him as "the one who has fits." If he has more seizures at school, things could get even worse for him. These circumstances might explain some of his behaviors, like his interest in dressing up as a girl. At this sensitive age, gossip and negative comments from others can be incredibly damaging. Perhaps the epilepsy itself won’t have a huge physical impact, but the social stigma and rumors could affect him for his entire life.
That was why Liu Banxia was so insistent on keeping him for observation; he had a responsibility to his patient.