The Enhanced Doctor

Chapter 1156: Chapter 1156: Dance of Death?

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"Teacher Liu, the patient’s CT shows negative for brain, but the liver cirrhosis symptoms are evident, and the blood test indicators also match," Xu Yino said.

"Has the patient regained consciousness?" Liu Banxia asked.

"Just regained, and the head wound was cleaned and stitched. However, because of the prolonged coma, their speech is still not very clear," Xu Yino said.

"Let’s observe the patient for a bit; this head-shaking symptom shouldn’t be underestimated," Liu Banxia said.

"Teacher Liu, have you made a disease inference leaning in any direction?" Xu Yino curiously asked.

Liu Banxia shook his head, "It’s hard to say right now. We need to observe the patient further to determine what’s truly happening with the cirrhosis."

Despite Liu Banxia’s words, Xu Yino was full of spirit. She believed Liu Banxia had an inclination, and observing the patient now was just to verify it.

Arriving at the patient’s bedside, Liu Banxia began to carefully observe.

"Hello, how are you feeling now? You understand the current situation, right?" Xu Yino asked.

The patient nodded, "The police officer also told me just now, ah... it’s all my fault."

"Do you usually drink alcohol? How much do you drink?" Xu Yino asked.

"I drink some at night when I get home; otherwise, I’m too tired to work during the day," the patient said.

"You shouldn’t drink anymore. Your test results show you already have cirrhosis. If you keep drinking, you could truly lose your life," Xu Yino said.

"Ah..."

The patient glanced at Xu Yino and sighed.

Liu Banxia frowned upon finding a new symptom in the patient during his recent observation. The patient’s foot also showed twitching symptoms.

The patient was definitely not in the mood to playfully shake their foot; in medical terms, this was a symptom of athetosis.

"How long has your foot been like this? Moving without your control?"

Before Liu Banxia could speak, Xu Yino asked.

"Over two months, maybe. I didn’t pay much attention at first, thought it was because I was cold from wearing less clothes in winter," the patient said.

"It was this uncooperative leg today; it was supposed to hit the brake, but it twitched and hit the accelerator. Then I crashed into someone’s house. How much will I have to compensate them?"

The patient was somewhat agitated.

"Doesn’t the car have insurance? Besides this symptom in your foot, do you have it anywhere else?" Xu Yino asked.

"I do, but it’s not obvious. There’s a little in my hand, and a little in my neck. But that just started these past couple of days. I was planning to visit the hospital once I was done with work to find out why I keep cramping."

"Is it because of this that you feel exhausted every day?" Liu Banxia asked.

"Yes, I keep having to pay attention but can’t control it. At home, I can only relax by drinking a little. Didn’t expect to drink my way into cirrhosis. Whatever I do is wrong, might as well crash and be done with it, make things simpler," the patient complained.

"Does anyone in your family, or any ancestors have had such symptoms?" Liu Banxia continued to ask.

"No. If they had, I would have known," the patient said.

"Just able to drive a car, but after this incident, who would dare let me drive again? Ah... life is really unbearable. The poorer you are, the harder it gets, the more suffering there is."

Xu Yino glanced at Liu Banxia, feeling a bit anxious.

The patient’s negative emotions were overwhelming, and she was worried the patient would lose hope after being discharged.

Sometimes, accumulating too many negative emotions can lead to making the wrong decision.

"Xu Yino, the patient exhibits athetosis, which are symptoms of dystonia, as well as cirrhosis and splenomegaly. What inference can be made?" Liu Banxia suddenly asked.

Xu Yino froze, her brain quickly beginning to work.

Sure enough, the great demon king had a hypothesis in mind, but what was this disease?

The patient lying on the bed suddenly seemed hopeful, suspecting this doctor might know what’s wrong with him.

"Teacher Liu..., I haven’t thought of it," Xu Yino thought for a moment but shook her head.

"It’s likely Wilson’s disease, an autosomal recessive metabolic disorder," Liu Banxia said.

"This means that there’s excessive accumulation of copper in the body which cannot be metabolized out. That’s why you’re exhibiting dark skin and cirrhosis."

"Carefully observe the junction of the patient’s cornea and sclera; you should be able to see a Kayser-Fleischer ring, greenish-brown or dark brown. Though this disease is aggressive, it can be treated through adjustments if detected early."

"Genetic disorder? No one in our family has had this disease, and none of my relatives have either." The patient said hesitantly.

"Hold on, let me take a look." Xu Yino quickly said, then pulled out her laptop and shone it toward the patient’s eyes.

Liu Banxia was still quite confident because the patient’s symptoms currently matched perfectly.

He was very relieved, knowing that if this disease progresses to the late stage, only splenectomy and liver transplantation remain viable; conservative treatments are useless.

It might even damage the kidneys, and at that point, there would be no solutions left.

"Teacher Liu, I don’t seem to see that ring." After observing for a while, Xu Yino said hesitantly.

"Not there? Let me see." Liu Banxia frowned.

He kept questioning himself internally. It shouldn’t be; the corneal K-F ring is the most significant symptom of this disease. Why isn’t it there? Did I judge incorrectly? Is it not Wilson’s Disease?

With a head full of doubts, Liu Banxia also took his laptop and examined the patient’s eyes.

Although not very comfortable, the patient persisted. No matter what this ’Wil’ disease is, as long as they can see something in his eyes, it’s fine, as long as it can be treated.

Upon careful examination, Liu Banxia’s frown deepened; indeed, he did not find the corneal K-F ring.

Then he placed the patient’s brain CT scans on the lightbox, given that the key radiographic indicator of this disease is the bilateral symmetric low-density of the lenticular nuclei.

Even though the radiology department had just given a negative indicator, he thought maybe they focused too much on the liver or overlooked the subtle expression.

After carefully reviewing, he sighed internally; the brain CT scans were clean indeed—he had misjudged; it is not Wilson’s Disease.

However, the heaviness in his mood was not due to his misjudgment but because if the patient’s current symptoms are not Wilson’s Disease, it might be a fatal disease with similar symptoms.

"Doctor, do I have ’Wil’ disease?" The patient asked nervously.

"We’ll need to wait a bit more, and study further." Liu Banxia pondered for a moment and said.

"Bring your elders over, and ask whether there have been any distant relatives with similar symptoms, or with incomplete intellectual development; this could help us diagnose."

"Doctor, can’t you diagnose it yet?" The patient asked.

Liu Banxia nodded, "You don’t have certain symptomatic indicators, so we need to consider other directions. However, with dystonia, we first need to rule out whether it’s congenital or acquired."

"Congenital means genetic, and acquired means it’s a temporary condition caused by some kind of substance stimulation. We need to be responsible for you, as it can save a lot of examination costs."

The patient nodded, "Alright, I’ll call my mom over. But if I really have a severe illness, don’t tell her, only tell me."

"She’s getting old and can’t withstand this kind of shock. I only have this one elderly mother left, and she shouldn’t worry because of my issues."

"Don’t worry, I will be measured." Liu Banxia nodded, giving assurance.

"Teacher Liu, could it be Huntington’s chorea?" After returning to the office, Xu Yino asked.

Liu Banxia pinched his brow, "I’m worried it is. This disease is life-threatening, and the best survival period seems to be about 20 years."

"Then...should we do a genetic test?" Xu Yino asked.

"I’m worried about this now; a genetic test is the simplest and most straightforward, but it’s quite expensive." Liu Banxia said.

"Unlike a CT scan, which can be settled for a few hundred yuan, he just had a car accident, even if the insurance could cover some, the losses he caused to his company might lead to some issues."

"You saw how he reacted earlier; I worry he won’t accept this test. Thousands of yuan—for some people, it might not be a big deal, maybe just a meal cost. But for others, it’s a huge sum."

"As doctors, we genuinely need to tailor our approach. For those not short on money, we just arrange the appropriate tests. For families with average conditions, if it can be diagnosed through other symptoms, that’s best."

Xu Yino nodded, "Teacher Liu, what else can detect Huntington’s chorea?"

Liu Banxia shook his head, "It’s hard to test, its latency is very strong. This disease, people call it the dance of death, because it develops slowly; even in the mid to late stages, unless you do genetic testing, it may not be detectable."

"But this disease does manifest early, affecting intelligence to some degree. So I intend to ask thoroughly once his mother arrives."

"After all, in the past, families with such patients generally avoided talking about them, and the younger generation might not know. He should be in the early stages now, so medically speaking, only genetic testing works."

"I also fear I might judge wrongly; if the test is done, the money spent, and it turns out not to be, then his financial burden could become very large."

"Oh... what should we do then." Xu Yino sighed too.

She too felt Liu Banxia’s consideration was thorough, exemplifying the ’calmness’ discussed over lunch today.

Calm consideration can yield all possible reasons from every angle, rather than deciding subjectively what to do.

If it were her, she would’ve done the genetic test immediately, saving time, trouble, and ensuring high accuracy.

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