CHAPTER 320: 320 CHILDREN WITH SCHIZOPHRENIA

People really aren’t taking care of themselves. The temperature difference between day and night is huge right now, and it’s easy to catch something if you’re not careful. This is especially true for those who frequent street food stalls; they have a few drinks, get all warmed up, and then what happens when a cool breeze blows by? Some just can’t handle it. The incidence of these kinds of colds, often brought on by wind and chill, is genuinely high, not much less than the flu in winter.

Besides, young people these days are quite fashion-conscious. This is the season for short sleeves during the day and long sleeves at night. But they tend to wear short sleeves all the time.

"Everyone, be careful! If you’re working late, put on an extra layer. Let’s not catch colds," Liu Banxia called out.

"Thank you, Teacher Liu!" everyone responded in unison.

Truth be told, this kind of atmosphere only existed when Banxia was the chief resident, given his rather ’lively’ personality. As long as you didn’t violate any fundamental principles, everything was fine.

"Dr. Liu, a special patient will be arriving soon. We need a quieter consultation room," Wang Ying announced.

"Sister Wang, what’s the situation?" Liu Banxia asked curiously.

"A nine-year-old boy with some mental health issues. It seems he also struggles with agitation, is prone to physical outbursts, and throws tantrums at loud noises," Wang Ying explained. "The dispatch nurse just informed me. Since our emergency center is newly opened and has fewer patients, he’s been referred here. He sustained a head injury after fainting, and it needs to be treated."

"Okay, Xu Hui and I will attend to him when he arrives. Notify everyone to be cautious," Liu Banxia nodded.

Even though he wasn’t a VIP patient of Second Hospital, they could still give this child VIP treatment. At such a young age, suffering from a mental illness was a torment not just for him, but for his entire family.

After about seven or eight minutes, the ambulance pulled up to the entrance. Today, it arrived quietly, without even its siren on.

"The patient’s vitals are stable. We administered some sedatives. There’s a 1.5-centimeter wound on his forehead; it’s quite deep," the paramedic reported as they wheeled the gurney in.

Seeing the child, Liu Banxia frowned.

The child lay still, sedated by the medication. However, Liu Banxia could see no fewer than five wounds of various sizes on his head, not counting the new one from today. He also noticed several small wounds on the child’s hands, some of which were unhealed scratches. Considering the child’s history of mental illness, he suspected these might be self-inflicted.

"How long has the child been sick?" Liu Banxia asked the boy’s mother once they reached the treatment room.

"It’s been over three years. He can’t go to school now, so I have to watch him at home every day. But I can’t keep an eye on him all the time," the mother said, tears welling up as she spoke.

"Please don’t worry yet; the wound is easy to treat. While the sedative is still effective, I’ll give him anesthesia and then suture it," Liu Banxia said softly.

Even with all his experience, he knew this family was going through immense hardship. Caring for such a child was clearly very taxing. The mother didn’t look very old, yet she already had a lot of white hair.

Liu Banxia carefully cleaned the boy’s wound, being extra cautious even when administering the anesthetic. However, the sting of the needle still woke the child.

He merely glanced at Liu Banxia, then closed his eyes again.

A child this age wouldn’t normally be so calm while getting stitches. Unless he’s already experienced something far more terrifying, how could he be so composed? Even an adult would have questions upon waking up in such a situation.

Liu Banxia felt a deep sympathy for the child and sutured the wound with even greater care and speed.

"Alright, keep it dry. Come back the day after tomorrow for a dressing change," Liu Banxia said softly after applying the adhesive tape.

"You stitch fast," the little boy said, looking up at him. After speaking, however, he frowned.

Liu Banxia was taken aback. The child seemed quite normal, not like someone with mental health issues or agitation and aggressive outbursts.

"You’re very brave. Other children would cry," Liu Banxia said.

"Is it fun to fool children?" the little fellow asked stubbornly.

This little guy is interesting,

Liu Banxia thought. He habitually reached out and ruffled the boy’s slightly long hair.

But after doing so, even he was stunned. This little boy has a history of mental illness and possibly agitation. What if I upset him by touching his head?

As Liu Banxia froze, the little boy also froze, his eyes welling up with tears.

"Rest here for a while with Uncle," Liu Banxia said, gently squeezing the boy’s shoulder.

The little fellow looked at him without saying anything, then lowered his head and thought for a moment before obediently lying down on the examination bed.

Liu Banxia turned off half the lights in the treatment room, gave the child’s mother a look, and they walked out together. Of course, before leaving, he had also removed any objects from the room that the child could use to self-harm.

"He seemed quite normal to me. What were the results of his previous examinations?" Liu Banxia asked once they were outside.

"We’ve had him checked so many times, but they couldn’t find anything wrong. Finally, a doctor said it might be early-onset schizophrenia. There are many triggers, but the main one is noise," the child’s mother replied. "Usually, he’s fine. But whenever there’s a loud or jarring noise, he has an episode. Sometimes he smashes things, sometimes he faints. When it gets too unbearable, he scratches himself."

As she spoke, the child’s mother began to cry again.

"But even so, there should usually be some signs. He should be especially wary of strangers. Yet, when I touched his hair just now, he seemed quite happy," Liu Banxia said, frowning.

"He hasn’t seen any outsiders for a long time. Although the neighbors don’t say anything, when we take him out, they look at him, and then he doesn’t want to go out anymore," the mother said. "We even thought about moving to the countryside, where it would at least be quieter. But that wouldn’t work either. If someone has a dog and it barks, he’ll have an episode."

"Have you had him checked recently? Symptoms like these can often be caused by lesions in the brain," Liu Banxia said.

"What else is there to check? We don’t even know how many CT and MRI scans he’s had," the child’s mother said with a bitter smile.

"Please wait a moment. Let me talk to our neurologist," Liu Banxia said.

He then slipped into Peng Bo’s consultation room and described the child’s situation.

"What you’re describing sounds somewhat interesting. It’s rare for a child this young to develop such a condition; most symptoms usually appear after puberty," Peng Bo remarked. "Moreover, clinically, this child’s presentation can only be classified as an undifferentiated type, which is very rare. Typical patients present as paranoid type, with hallucinations and delusions, or tension type, characterized by constant anxiety."

"But regardless of the classification, there’s usually one or more disorders of perception, thought, emotion, volition and behavior, or cognitive function."

"When you first said the child seemed indifferent after waking up, I thought it might be an emotional disorder. But your touching his hair, which made him feel a connection, rules that out."

"Peng Bo, what do you think is going on? Why don’t you come and see the child with me?" Liu Banxia asked, a bit anxiously.

"Hold on, let me think about it. Ideally, we should observe him for a longer period, especially to see what happens when he has an episode," Peng Bo said with a smile. "Besides, our current discussion is a process of elimination. Based on your description, it seems the child is primarily sensitive to noise and has violent and self-harming tendencies, correct?"

Liu Banxia nodded. "And he also faints."

"Then you’ll have to persuade the child’s mother. He needs an EEG and a brain CT to check for any lesions in the frontal lobe, temporoparietal region, or occipital lobe," Peng Bo said. "Generally, lesions in these areas are what cause schizophrenia. If those tests are also clear, then it will be very difficult to diagnose."

"That’s what I’m worried about. This child, no matter how you look at him, seems normal. It’s heartbreaking. His hair is quite long; it’s probably because he’s uncomfortable with haircuts," Liu Banxia said.

"I have one more patient here. After I’m done, I’ll go over and take a look," Peng Bo said with a nod and a smile.

"Great. I’ll go stay with the child and his mother for now," Liu Banxia said and walked out.

Peng Bo shook his head. It was only his second day working properly with Liu Banxia, and he was already impressed by his passion. Perhaps this is typical of emergency department doctors.

"Is the child okay? The neurologist will come over after he’s finished with his current patient," Liu Banxia said when he returned.

"Doctor, will he be able to find out what’s wrong?" the child’s mother asked.

"The neurologist recommended an EEG and a brain CT. I don’t think it’s straightforward schizophrenia. With a three-year history, if it were schizophrenia, he likely wouldn’t appear as normal as he does now," Liu Banxia said.

His words rekindled a spark of hope in the child’s mother. Her son was usually very resistant to strangers, yet he had been fine when Liu Banxia touched his head.

Liu Banxia gently opened the door and peeked inside. The little boy seemed to be asleep, lying quite peacefully on the bed.

Before he could close the door, a loud cell phone ringtone echoed through the corridor. A patient took out his phone and started talking loudly.

"AHH... AHH... AHH..."

Before Liu Banxia could even assess the child’s condition, he saw the boy thrashing on the bed, screaming as he writhed.

This gave Liu Banxia a terrible fright. Although the ringtone in the corridor had been loud, it wasn’t excessively so by the time the sound reached the treatment room.

Without a second thought, Liu Banxia rushed in and held the little boy, terrified that he might injure himself in his frenzy or tear open the stitches on his head.

Even with Liu Banxia holding him, the child continued to struggle, kicking his legs relentlessly. Finally, his eyes rolled back, and he fainted.