CHAPTER 491: 491 SPECIAL FIELD INVESTIGATION TEACHING

(Thank you KXJL671112 for the gift of fifty thousand coins, waiting anxiously for the encouragement of monthly tickets.)

"This severe lung inflammation and damage should be considered lung failure. Now there’s hematuria. Although the latest test results aren’t out yet, it’s likely kidney failure as well," Liu Banxia said after adjusting the patient’s medication.

"The disease is too aggressive. First, a lung infection complicated by empyema, and now kidney failure. I’m afraid the liver and heart will be affected soon. Can we still perform surgery at this stage?"

Chen Xuehai, who had just completed a cardiac bypass surgery, shook his head. "First, we need to stabilize their kidney function. Otherwise, the damage to the patient would be even greater. Besides, the culture results will be out soon, so let’s see what they show."

"If we’re lucky, conservative treatment and thoracic drainage will suffice. If our luck is worse, then we’ll need to address it more thoroughly."

"It’s truly strange, how did it progress so quickly? The patient’s wife was also experiencing dyspnea earlier. To prevent her condition from becoming critical later, we intubated her after discussing it with her. You’ve been quiet, what are you thinking about?" Wang Huan finished speaking and then asked Liu Banxia.

Liu Banxia replied, "It’s nothing. Intubation was the right choice. Her blood oxygen levels were already falling. Even if oxygen administration could have maintained them, we would have needed to intubate if we couldn’t determine the cause of her condition."

"By intubating her now, we can provide the maximum oxygen supply. This can slow the progression of her illness, giving us time to gather more information from her husband."

"I’m not talking about the intubation," Wang Huan shook his head. "I mean, what are *you* considering? You usually go quiet like this when you’re deep in thought."

The interns present nodded in unison. It was true.

Liu Banxia wasn’t a chatterbox, but he wasn’t usually short on words either. Whenever he got this quiet, it meant he was either figuring something significant out or on the verge of it.

"Am I really that bad? I was pondering the cause of their illness," Liu Banxia said helplessly.

"We’ve already ruled out environmental factors. Their travel history, work environment, living environment—we’ve excluded them all."

"Their lung lesions must have existed before their trip. Their work involves traveling around for livestreams. As for their living environment, their parents, who rushed over, are very healthy."

"But when I think about it, for a chronic lung disease to progress to this extent in a person, it doesn’t happen overnight. It must be the result of long-term exposure to such an environment or pathogen to cause the current outcome."

"As for why their conditions suddenly worsened after returning, it could also be the body’s stress response. After all, although it’s not extremely cold here, the temperature has dropped significantly recently."

"Brother Wang once said something that left a deep impression on me. He said that many times, doctors are just guessing, sometimes..."

"Stop right there! When did I ever say that doctors have to guess blindly?" Wang Huan interrupted.

During such a serious discussion of the patients’ conditions, a formal consultation, Liu Banxia was actually claiming that he, Wang Huan, had said doctors just guess blindly!

"Don’t you remember?" Liu Banxia said. "That patient with endocarditis caused by dental caries? When you first examined them, you said you had a bad feeling, that it might be very serious, and they were sent to the ICU right after the check-up."

"I said that was intuition, not blind guessing!" Wang Huan retorted. "Enough of that. Get back to what you were saying. What have you thought of?"

Although the interns knew the situation was serious, they found the exchange quite amusing.

"What I wanted to say is, even though we’ve eliminated environmental factors, we still have that nagging doubt, don’t we? Because our first instinct points to environmental factors," Liu Banxia said.

"So, I plan to discuss with the family whether we can conduct an on-site inspection of their home. Maybe there’s mold somewhere in their room, or some other substance has caused their chronic lung disease."

"Their parents probably don’t frequent their private living spaces, right? In that case, could this allow us to reconsider their immediate living environment as a factor?"

"Eh, I have to say, Banxia, your ’guess’ actually sounds somewhat reasonable," Wang Huan nodded, returning Liu Banxia’s earlier jab with a teasing look.

"Since we have this idea, let’s do an on-site visit. Although we don’t have a precedent for this, it should be manageable since the patient load isn’t too heavy right now," Chen Xuehai also agreed.

"Okay, I’ll inform the director. Brother Wang, please talk to the family about this, and ask them to have someone go back to the house to open the door for me," Liu Banxia said.

"Teacher Liu, I want to go too," Xu Yino spoke up.

"Come along."

"Me too."

"And me."

"Teacher Liu..."

...

Looking at the enthusiastic interns, Liu Banxia said helplessly, "I’ll ask the director first. If he approves, you can all come. If not, we’ll have to draw lots."

After understanding the situation, Zhou Shuwen nodded. "This is quite interesting; it could be a special kind of teaching lesson. So, take them all. Are any of them licensed to drive? You can take my car."

"Director, will you be able to manage things here if something urgent comes up?" Liu Banxia asked.

"What’s there to not manage? We’ll all pitch in," Zhou Shuwen said. "Go on, don’t worry. Be meticulous during the inspection and try to make it a quick trip."

"Alright, we’ll try to be back as quickly as possible," Liu Banxia replied.

The family had no objections to this on-site inspection. After all, it was for the patients’ treatment. Moreover, they had never heard of doctors from any hospital personally going to a patient’s home to investigate for treatment.

Putting everything else aside, this level of dedication alone had earned their deep respect.

Although the couple had earned some money from their livestreams over the past two years, it wasn’t enough to afford a villa in a high-end complex like Linyu Villa. Theirs was in a mixed development of villas, Western-style houses, and high-rises, located quite a distance away.

When they, dressed in white coats and masks, got out of the car, they startled the people strolling around the complex. Their appearance was rather alarming, and the onlookers had no idea what was going on.

Liu Banxia and his team didn’t have much time to explain. The drive itself had taken nearly forty minutes, and the two patients back at the hospital couldn’t afford for them to delay.

The three-story villa looked quite nice.

Once inside, Liu Banxia directed the interns to disperse. If they found anything suspicious, they were to take samples, label them, and keep them for testing in the hospital laboratory.

Truth be told, our daily lives are teeming with bacteria—in our sinks, dishcloths, cutting boards, and bathrooms.

The couple’s master bedroom had an en-suite bathroom with a large bathtub, which was another area of suspicion.

Laziness is actually a significant hazard in housekeeping. Whether in the kitchen or the bathroom, any lapse in diligence can create a breeding ground for bacteria.

Why didn’t Qiaoqiao like to cook at home? It was because she found cleaning up too troublesome. But even so, she would regularly clean Tang Dou’s small toys, little blankets, food bowls, and so on.

Of course, aside from the food bowl and toys, her standard for cleaning other things was simply to replace them with new ones. That was typical Qiaoqiao.

"Teacher Liu, it seems like there’s nothing particularly unusual," Xu Yino reported after they had checked everything.

"I’ve thoroughly examined their bedroom—the bed, the wardrobe—and found nothing," Huang Bo added. "I even checked the numerous flower pots on the bay window and took soil samples to be tested back at the hospital."

"I have a feeling that something isn’t quite right, but I can’t quite put my finger on what it is," Liu Banxia furrowed his brows.

He strongly suspected that some substance or pathogen in their home environment had caused the chronic lung disease, but so far, the inspection hadn’t revealed anything out of the ordinary compared to a typical household.

Even if some areas prone to bacterial growth showed some mold, it wouldn’t be enough to cause their current severe symptoms.

After all, the husband’s parents also lived here, and they were the ones who used the kitchen most. The young couple mostly just ate.

Frowning, Liu Banxia dialed Wang Huan’s number.

"Banxia, how’s it going?" Wang Huan asked as soon as the call connected.

"We haven’t found anything unusual yet, but something still feels off. What are the lab results? What pathogen did you find?" Liu Banxia asked.

"It’s Nocardia," Wang Huan answered. "We’ve started them on a combination of sulfonamides and penicillin, along with thoracic drainage. If that’s not effective, they’ll need a thoracotomy for debridement."

"Nocardia is commonly found in the environment, so it might be related to their trip. However, that’s not the main reason their condition is so severe. We’re still investigating the underlying lung issue."

"We’ll continue looking around here. I’ll hang up for now," Liu Banxia said and ended the call.

Nocardia is a gram-positive bacterium and isn’t easy to treat. The rash on the patient’s body was an external manifestation of this bacterium.

Although this bacterium was difficult to treat, and while it was likely linked to the patient’s empyema, what was the primary lung disease?

Liu Banxia didn’t give up and continued wandering up and down the villa’s three floors again.

After another tour of the house, Liu Banxia slapped his forehead. That’s right! He finally realized what felt off. They’re livestreamers. Why haven’t I seen any of their streaming equipment?

The couple had mentioned they rushed to move in to start their livestreams. But all the inspected areas were normal living spaces, with no sign of any streaming gear.

They were supposedly quite successful streamers; surely they couldn’t just be using a mobile phone, could they?

"They always livestream in the basement," the patient’s mother, who had returned with them to the house, explained. "Sometimes, when they sing or something, they soundproofed the basement to avoid disturbing us."

"Let’s go take a look then," Liu Banxia suggested.

The patient’s mother nodded and led them to the basement.

It was actually a semi-basement. There was a small living area outside with a TV, game consoles, and other entertainment equipment. The door to the inner room was thick and soundproofed, much like one you’d find in a KTV.

The moment he stepped into the room, Liu Banxia’s eyes lit up, and he quickly took out his phone.