CHAPTER 463: 463: A BLACK DAY - PART ONE

"Monitor him for now. Let me know when the serum results come in," said Liu Banxia.

Wang Chao nodded. There really weren’t any other options. They couldn’t communicate with the patient, and his family members still weren’t around.

"What’s up? You seem a bit off?" Wang Huan asked once Liu Banxia had finished his tasks.

"I’m just frustrated. Neither of our patients shows clear signs of their illness. We’re essentially left to guess," Liu Banxia responded with a bitter smile.

"It’s just unfortunate timing. At least you have a hypothesis for the man in the emergency department. As for the VIP upstairs, are we going to conduct instrument checks tonight?" Wang Huan asked.

"I’m starting to hesitate. I’m not sure if we should keep observing for now," Liu Banxia frowned. "Her condition is too complicated. We’re genuinely left in the dark. While more tests might help validate our guesses, I doubt they’d be of much use."

"Teacher Liu, my auto-brewery syndrome patient’s condition has changed," Huang Bo said, walking over again. "The fluconazole doesn’t seem to be effective. The patient is showing mild brain fog symptoms today. Does this indicate drug insensitivity?"

Liu Banxia rubbed his face. This was more bad news.

Even healthy individuals can occasionally experience brain fog. This can manifest as mental confusion, poor concentration, and headaches, which naturally influence one’s emotional state.

Sometimes, after sitting for a long time, we might feel something similar. This can be alleviated by standing up, moving around, chatting with a colleague, or admiring a distant view.

However, alcoholics often experience similar symptoms due to chronic drinking. This patient’s condition was unusual: his gut produced alcohol even though he didn’t drink. Even without chronic drinking, such symptoms could occur because his body’s alcohol content was somewhat high.

This aligned with Huang Bo’s earlier statement about the patient’s insensitivity to fluconazole.

"Let’s try itraconazole instead, at the same dosage. Keep a close eye on the patient, and make sure he doesn’t consume any foods high in carbohydrates," Liu Banxia suggested after some thought.

Huang Bo nodded and rushed off again.

"Teacher Liu, can you come over here and see if this patient’s cervical spine is injured?" Liu Yiqing called out.

"I’ll be right there," Liu Banxia replied. "Brother Wang, I’m swamped. Can you wait for Brother Hui to take over before running the thoracic-abdominal-pelvic examination for the patient upstairs? We can’t skip it; we need to rule things out."

Wang Huan nodded. "I understand. You better hurry over."

Liu Banxia hastily went over to Liu Yiqing’s side and noticed Liu Yiqing winking at him repeatedly. He was taken by surprise. What was she getting at?

"Teacher Liu, the patient is a fifteen-year-old girl who fell and hit her neck on her way home yesterday," Liu Yiqing explained.

Liu Banxia nodded vaguely and, pulling back the curtain, walked in.

The girl was sitting on the exam table with her back to him, her down jacket placed to the side. Looking at the bruise on her neck, Liu Banxia furrowed his brow.

"Let me palpate a little to see if there’s any cervical spine damage. Cervical spine injuries might not be obvious at first, but they can cause serious problems."

Though he didn’t understand why Liu Yiqing had asked him for a consult instead of just ordering an imaging test, he decided to go along with it for now.

Liu Yiqing came to the bedside and pulled down the girl’s sweater collar while Liu Banxia was examining her cervical spine.

While examining the girl’s neck, Liu Banxia noticed the other marks and sighed inwardly. The girl’s injuries were definitely not from a fall; there were three other bruises extending down from the back of her neck.

"There seems to be no problem with the cervical spine, but I see the scalp has been bruised too, right? Have you felt dizzy?" Liu Banxia asked.

"Doctor, just a little bit. She didn’t eat breakfast this morning," the girl’s mother replied.

"I see. Let’s arrange for a nurse to take her for a head CT scan. Some head injuries may have delayed bleeding, so it’s better to be sure and put our minds at ease," Liu Banxia suggested.

"Alright, please write the order for us. We’ll pay right away," the mother agreed.

"Zhou Qian, take this girl to the CT room," Liu Banxia instructed.

Liu Yiqing gave him a look but remained silent.

"Teacher Liu, do you think it’s domestic abuse? I didn’t dare say anything earlier when her mom was around," Liu Yiqing asked once Zhou Qian and the girl had left.

"How did the mother and daughter behave during the consultation?" Liu Banxia asked.

"They seemed alright, I guess. But the child never said a word. It was her mother who did all the talking," Liu Yiqing replied.

"It’s hard to tell whether it’s domestic violence or school bullying, but I lean towards the latter. If it were domestic violence, I don’t think her mother would have brought her to the hospital," said Liu Banxia. "But you can’t be certain. It might also be a case of domestic abuse the mother isn’t aware of. You should speak to her again later, but be indirect with your questions."

"This falls within our duty to communicate with the patient’s family. It’s important to avoid unnecessary hostility. It’s our obligation to bring this up, but we need to be tactful about it."

Liu Yiqing nodded in agreement.

Still, Liu Banxia creased his brow. Something seemed off about Liu Yiqing today; she seemed preoccupied. She wasn’t usually like this. As one of the ’two flowers’ among the general surgery interns, she and Xu Yino usually enjoyed their days. After all, girls often received certain advantages wherever they went.

"President Liu, President Liu! The diagnosis is confirmed; it’s measles!" Wang Chao rushed over excitedly, just as Liu Banxia was deep in thought.

DING! Consultation task completed.

Awarded 200 experience points, and 100 points proficiency in diagnostic skills.

"This is the first piece of good news I’ve heard this morning. Standard treatment will suffice. Thank goodness it’s not some other infectious disease," Liu Banxia said with a smile.

"Even if it was a guess, that’s impressive!" Wang Chao said, giving a thumbs up.

"Sigh... no need for flattery. After transferring the patient, let’s thoroughly disinfect Resuscitation Room One," Liu Banxia said.

Measles wasn’t such a terrifying infectious disease in their country anymore, as everyone got vaccinated. Only people with unique constitutions or some children got infected. Compared to other infectious diseases, this one wasn’t a major concern.

However, the driver who brought the patient wasn’t so lucky and needed to be quarantined. He could only be released once it was confirmed he wasn’t infected, and his vehicle would also require full disinfection. This man also had to be reported; it was a required procedure, especially since he was a foreign national.

"Teacher Liu, that child might have been bullied!" Liu Yiqing exclaimed, running over just as he was trying to catch his breath and drink some water. "Zhou Qian sent me a message. The child always looks down when walking and doesn’t dare to make eye contact. Moreover, whenever she encountered men, her body would tremble, and she would lean away."

"Damn!" Liu Banxia couldn’t help swearing. A fifteen-year-old girl, subjected to such a horrifying experience!

"Have you communicated with the child’s mother?" Liu Banxia asked in a deep voice.

"Not yet. Zhou Qian sent the message just before I could," Liu Yiqing hurriedly replied.

"A male doctor dealing with this isn’t ideal. Get Zhou Li; let her talk to the mother," Liu Banxia said.

The situation had now escalated to a criminal level. However, handling this was not within their capacity. All they could do was seek the family’s opinion on whether to report it to the police.

The bit of good mood that had just surfaced was instantly disrupted by this incident.

"Car accident victim, male, around forty. His blood pressure dropped rapidly in the car—50/80, heart rate 120. He’s conscious but unable to provide information." At this moment, emergency personnel rushed in with a gurney.

"Resuscitation Room Two," Liu Banxia quickly ordered.

"The patient’s eyes and skin show signs of jaundice," said the paramedic.

Liu Banxia nodded.

"One, two, three, transfer the patient. Connect the monitor. Abdomen is slightly hard. Fast blood test, cross-matching. Open another IV line and prepare for blood and fluid transfusion. Wang Chao, examine the head. Bedside ultrasound, ready," Liu Banxia instructed after the patient was moved.

"The head examination is complete; the wound isn’t serious. But the patient’s cervical spine cannot be examined; the patient cannot give valid responses," Wang Chao reported while Liu Banxia was still auscultating.

"Lung and heart sounds are normal. Bedside ultrasound," Liu Banxia said, putting away his stethoscope.

After applying the couplant, Liu Banxia scanned a few times and frowned. "Large amount of fluid in the abdominal cavity. Let me try to scan the liver. Book an operating room."

"No, the liver can’t be seen clearly. Xu Yino, come with me to the OR. Get in touch with the family as soon as possible and determine the patient’s name," Liu Banxia said after a few more scans.

Hearing his command, Xu Yino and the nurse hurriedly pushed the gurney towards the operating room.

"Teacher Liu, why are you in such a hurry to find out the patient’s name?" Xu Yino asked while scrubbing in.

"I’m worried about his liver. The jaundice is too severe, and I’m afraid he has a major underlying liver disease. It’s highly probable his liver was ruptured in this accident," Liu Banxia said.

Xu Yino paused. Of course, she knew that if a patient with existing liver disease suffered a liver injury, it was tantamount to receiving a death sentence.

After scrubbing in, Liu Banxia shook his head to clear his somewhat cloudy mind. There hasn’t been a single piece of good news today. Tang Feifei’s illness remained a mystery; he’d only guessed at measles. The patient with auto-brewery syndrome had deteriorated. The recently admitted fifteen-year-old girl had endured such a horrifying experience. This latest patient’s survival was also uncertain. This was a black day. Even though working in the emergency center meant not every patient could be saved, he didn’t want to accumulate so many negative emotions. Otherwise, it would affect his judgment.

After calming himself for less than a minute, Liu Banxia entered the operating room. The next few hours belonged to this patient.