The Enhanced Doctor-Chapter 585 This is true skill

(Thanks to kakazaza, Book Friend 20190727205832637, and Qing Lian Sui Feng Piao for the encouragement with monthly votes)

"Teacher Liu, has something come up?" Xu Yino asked curiously, having unintentionally caught the expression on his face.

"Think carefully. Has your father ever choked while eating? Or dropped food on the table when picking it up with chopsticks?" Instead of answering Xu Yino, Liu Banxia stared at the patient’s daughter and abruptly posed this question.

The patient’s daughter nodded blankly. "You can’t talk while eating; you’ll choke if you do."

Although I have no idea why Liu Banxia is asking these questions, I feel like he might have discovered something. After answering, she looked at Liu Banxia expectantly.

This time, Liu Banxia didn’t say anything. Instead, he grabbed both of the patient’s arms and shook them slightly in mid-air. After putting the patient’s arms down, he moved closer to the patient’s head and carefully examined his face.

"President Liu, what on earth have you discovered?" Xu Guosheng asked, his curiosity piqued.

"Doctor Xu, if it’s myasthenia gravis, could it also cause respiratory distress, similar to asthma?" Liu Banxia inquired.

"Myasthenia gravis? Oh my... that’s entirely possible! If it also affects the respiratory muscles, it will indeed cause respiratory distress," Xu Guosheng exclaimed in excited surprise.

After saying this, he also lifted the patient’s arms to assess the patient’s control over them. Then, he lifted the patient’s feet, asking him to perform a kicking motion.

Even though a specific examination hadn’t been conducted yet, the current situation made it quite clear. It was almost certainly the case.

"Doctor, have you figured out what illness it is?" the patient’s daughter asked cautiously.

Liu Banxia nodded. "It’s almost certainly myasthenia gravis causing his current condition. We’ll perform a neostigmine test shortly; we should see an effect in about fifteen to thirty minutes."

I don’t really understand what ’myasthenia gravis’ means; I can only guess from the words themselves. But one thing is clear: Dad is saved!

The patient was moved into the ICU and given an intramuscular injection of neostigmine.

Then, Liu Banxia and his group gathered by the bedside, watching the patient intently.

Although they had a strong suspicion, Liu Banxia and the others didn’t dare to extubate the patient yet. What if their guess was wrong? It could very well endanger the patient’s life.

They waited a full twenty minutes before they began to further assess the patient’s arms and legs.

"President Liu, it can be confirmed now. It’s myasthenia gravis. Although it’s not very pronounced yet, there’s already an improvement. It should reach its peak effect in about half an hour, right?" Zhang Zhiyuan asked.

Liu Banxia nodded. "That’s about right. We went in circles, and it was right under our noses all along. We all missed it."

DING! Task: Diagnose the patient with strange respiratory distress—completed.

Earned 200 experience points, 100 diagnostic skill proficiency points, 5 Glory Points.

"Once the drug reaches its peak effect in a bit, we can extubate him and transfer him back to a regular ward for oral neostigmine treatment, right?" Zhang Zhiyuan asked.

"Let’s do that. In a regular ward, he can also be with his daughter, which will greatly help his mood," Liu Banxia said. "By the way, Su is officially starting today, so don’t be too hard on him. He’s an honest kid who won’t complain; you don’t want to break him right away."

Zhang Zhiyuan rolled his eyes. "How could I do that? I’ll be too busy cherishing such a treasure."

The interns chuckled. After all, this was where they would be interning in the near future.

How on earth did Teacher Liu discover the patient had myasthenia gravis? they wondered, though they knew the ICU wasn’t the place to ask.

"Don’t worry," Liu Banxia said after they stepped out. "After observing him for a little longer, he can be transferred to a regular ward. We’ve confirmed the diagnosis; it’s myasthenia gravis."

"Doctor, what causes that? Is it that allergy thing you mentioned?" the patient’s daughter asked.

Liu Banxia shook his head. "To be precise, this disease is related to nerve conduction. It’s a type of autoimmune disease that occurs when there’s an issue with the transmission of signals from nerves to muscles. But you don’t need to worry. There are established treatments available. Medication can effectively alleviate the symptoms, and the prognosis is very good."

"Many factors can trigger it: infections, excessive fatigue, post-surgical stress, trauma, psychological factors, and so on. Clinically, it presents as a sudden worsening during an acute phase, with difficulty breathing. Like your father. When he was seen yesterday, his condition was considered mild myasthenia gravis. He could move on his own, and although his breathing was somewhat labored, he could still maintain his body’s oxygen needs. However, once it enters the acute phase and meets the criteria for severe myasthenia gravis, the nerve signals can’t be accurately transmitted to the respiratory muscles, leading to acute respiratory distress."

"Considering the patient’s presentation, I personally lean towards a psychological factor. In other words, it’s quite likely a result of him missing your mother. Moreover, this condition has shown signs before, they were just overlooked. For instance, the patient would feel extremely tired after physical activity but much better after resting. You can try to recall: the patient often had good energy in the morning, but by noon or afternoon, he would tend to appear listless."

"Yes, yes, that’s exactly right," the patient’s daughter said hurriedly. "At first, we thought it was just the lingering effects of a cold. He’d drink hot water at home and sweat it out, so we didn’t pay too much attention."

"Although today was very stressful, myasthenia gravis can be very deceptive. It’s often mistaken for pneumonia or a cold. The patient’s cough is actually because the respiratory muscles are affected, making it difficult for him to effectively clear irritants. A few days in the hospital with steroid treatment should help him improve. However, after he’s discharged, he needs to maintain a relaxed state of mind. Otherwise, it might relapse at any time, so it’s good for you to be mentally prepared."

The patient’s daughter just kept nodding. As long as it was treatable, that was enough for her; as for how tense and chaotic things had been today, she had long since pushed those worries to the back of her mind.

Now that Dr. Liu mentions it, and I think back carefully, there really were a lot of unusual things. For example, Dad didn’t lift his feet much when walking, spent much more time lying on the sofa or bed, had a decreased appetite, and generally felt unwell, and so on. These should have been recognized as unusual symptoms, yet both Dad and I just dismissed them as normal. Even when this very doctor had repeatedly questioned me earlier, I hadn’t considered these abnormalities significant.

"Doctor, my attitude today was terrible. Where is that other doctor? I must go and apologize to him," the patient’s daughter said after a moment’s hesitation, her voice full of remorse.

"He’s still downstairs seeing patients," Liu Banxia said with a nod. "He understands how you must have felt."

"There’s one crucial thing to remember: you’ll need to do a good job helping your father with his emotional well-being. Getting a pet is a good idea; it can provide him with an emotional anchor. Otherwise, he’ll often be alone, and his mind will drift to the past. Having a small animal around—whether it’s being playful and mischievous or just needing care—will give him something to focus on and keep him busy."

"Okay," the patient’s daughter said. "I’ll go buy one then. Would a husky be alright? That would definitely keep him on his toes, so he wouldn’t have time to dwell on other things."

"Haha, that’s entirely up to you," Liu Banxia said with a laugh. "Actually, getting a pet, developing a new hobby—anything like that would be good."

The patient’s daughter was a straightforward person; otherwise, she wouldn’t have become so agitated earlier. Liu Banxia had no intention of interfering with her decision to apologize; that was a matter between her and Xu Hui.

"Teacher Liu, how did you figure it out?" Xu Yino couldn’t resist asking as they walked downstairs.

"I always felt there was something odd about the patient’s condition, but I couldn’t pinpoint what it was," Liu Banxia said. "In the ward, the patient had tried to wave his hand. At the time, I attributed the limited range of his hand movement to his breathing difficulty. I also noticed his eyelids were drooping slightly. However, that’s not a very specific sign; many people experience it. It could be from not resting well or even eating something late at night. But just now, something felt off. He’d been on the ventilator for so long, and his blood oxygen levels had long since returned to normal. If it wasn’t an asthma attack and it wasn’t pneumonia, why was he still so exhausted and weak?"

"Sigh... Actually, I’m also to blame. I was so focused on his asthma that I overlooked other possibilities. We’ve diagnosed a fair number of myasthenia gravis cases over the years; we all need to be more vigilant. It’s highly deceptive. These patients often experience muscle weakness for a long time, so it can easily be misdiagnosed as something else. If the bronchodilator hadn’t eased his breathing, thereby ruling out asthma, I wouldn’t have dared to try the neostigmine test."

"Why?" Xu Yino asked offhandedly.

Oh no, why did I ask that? I remember now, neostigmine should be used with caution in patients with bronchial asthma! she thought, regretting it the moment the words left her mouth.

"I’ll treat you to a chicken leg at lunch as a penalty," Xu Yino said, raising her hand.

Liu Banxia nodded in satisfaction. "Excellent. Admitting your mistakes and learning from them—that’s the spirit of a good comrade."

The others nearby chuckled to themselves. You had to be careful when dealing with Demon King Liu. He was leagues ahead on the path of scamming chicken legs and pig’s trotters; they could barely keep up.

However, they were also deeply impressed. We’ve been following him for so long and saw the same patient, but none of us spotted it. That kind of insight wasn’t just for show. It was genuine ability, true skill. If Liu Banxia hadn’t thought of it, the diagnosis would likely have been delayed much longer, subjecting the patient to more tests and making his daughter even more "irritable."