Chapter 600: 591 Self-Destructive Appearance (Alliance Leader Wu Long Tie Guan Yin Bonus Chapter 1)

Although the internal medicine doctor didn't understand Zheng Ren's meaning, they still followed his orders and went to the consultation room to write a prescription.

"Hello, I'm the Inpatient Chief of the Emergency Department." Zheng Ren approached the woman holding the child and spoke gently.

The woman struggled to hold the child, trying to make his movements a little gentler.

Because she exerted too much force, traces of sweat could be seen on her forehead and temples.

The woman raised her head; her eye sockets were red, without tears, yet one could feel the sorrow immersed deep in her heart.

"When did the child start behaving like this?" Zheng Ren asked.

"Don't you think I'm abusing the child?" the woman's voice slightly hoarse, "All doctors think that! You can't find the illness, so you say……"

"Please keep your emotions calm." Zheng Ren shook their head and said: "I don't think these wounds are caused by you abusing the child. This is a rare disease, so I need some tests and your medical history to confirm."

Upon hearing Zheng Ren say that, her angry and sorrowful emotions eased slightly.

Observing Zheng Ren closely, I saw they wore a white coat, their posture straight, their face angular, their short hair black, their bright eyes revealing…… kindness?

Clearly under thirty, the doctor nevertheless bore the demeanor of an experienced senior director.

Just a glance, and one could feel on them a sense of having weathered many battles.

The child's mother felt somewhat moved by their trust in Zheng Ren, especially the aura they exuded, which gave her an inexplicable confidence.

Regardless of whether it can be cured, this doctor should be able to understand the illness.

"Doctor, the child has liked to gnaw his fingers since birth. When he was little, I didn't notice and thought it was like other children." The mother recounted: "But as he grew older, his habit of chewing his fingers became worse."

Zheng Ren nodded, which matched their own judgment roughly.

"He learns slowly, only walking after over two years old, but I truly haven't despised him; no matter what, he's my child." The woman said painfully: "Later, when he could walk, he began to stab himself with objects, especially his face."

"We had no choice but to tie his hands up. Yet he still bites his own lips, especially when eating."

"We've taken him to Hai Cheng and Sheng Cheng for checkups; they all said the child was fine, and the doctors thought it was me and his father abusing him."

The medical history was simple; having said this, the emergency department internal medicine doctor walked out holding the emergency form.

"Here is a blood test order; go pay and then have the test done." Zheng Ren said: "After the test, I might be able to give you an accurate diagnosis."

Although Zheng Ren's words were still somewhat vague, this is a doctor's professional habit; there's nothing to be done.

Watching the patient's mother carry them away as the father walked ahead to pay and prepare for the test, the emergency department internal medicine doctor scoffed.

"Chief Zheng, it's just child abuse; I've never seen anyone treat them so excessively. They're basically not human, outright scum, deserving of annihilation."

"No." Zheng Ren sighed again: "You didn't notice that the child's most severely injured part is the lips?"

The emergency department internal medicine doctor recalled that the child's lips were indeed the most severely injured, with old and new wounds accumulating, to the point that the lips had become deformed.

But so what?!

They remained unconvinced, puffing their cheeks as they stared at the ground.

"If I haven't misjudged, the child likely has Lesch-Nyhan syndrome." Zheng Ren's face looked somewhat grim.

"What?"

"Lesch-Nyhan syndrome, also called self-destructive appearance syndrome, is an X-linked recessive congenital disorder of purine metabolism caused by deficiency of hypoxanthine-guanine phosphoribosyltransferase (HGPRT)." Zheng Ren explained to the emergency department internal medicine doctor.

Hearing the terms purine…… hypoxanthine…… guanine…… ribonucleic acid, etc., the emergency department internal medicine doctor dazedly felt as if they had returned to university, sitting in a biochemistry class.

The person standing before them was not the young Chief Zheng, but an old scholar with white hair.

Lacking this enzyme prevents hypoxanthine and guanine from being converted to IMP and GMP, leading to pathological breakdown into uric acid. Therefore, the child's blood test should show high uric acid; after we get the results, we can make a preliminary diagnosis.

"Really?"

"Hmm." Zheng Ren nodded: "If we were to do a bilateral kidney ureter ultrasound, we might find kidney stones. But the patient's family isn't well-off, so we should save where we can."

"Um……" the emergency department internal medicine doctor concluded.

"The patient has low intelligence, with characteristic compulsive self-injurious behavior; the diagnosis of this disease should be unproblematic."

What Zheng Ren said sounded too true.

The emergency department internal medicine doctor almost believed it.

"If the diagnosis is clear, why are you sighing?" the emergency department internal medicine doctor asked.

"Diagnosis does not equal treatment." Zheng Ren said: "For this disease, existing medical means are unsolvable."

"……"

"Moreover, most importantly, the patient rarely lives past twenty."

Zheng Ren also didn't want to say that, but the fact remains the fact; it won't shift due to their subjective wishes.

Such a situation is something all doctors are unwilling to face.

Whether one can see the illness clearly is one matter.

Whether one can treat this disease is another matter.

But no matter how one thinks, the vast majority of doctors hope the patient can walk out of the hospital healthy.

Diseases that leave one helpless are similar to cancer, which doctors also often encounter.

But this time, it's somewhat different.

The emergency department internal medicine doctor still harbored doubts, but was already leaning toward believing Zheng Ren's words.

Unable to treat……

This result is too cruel.

But,

Nobody can do anything.

All we can do is look forward to progress in medical technology.

Life is inherently a reverse journey.

If there were more time, it would always be better. The child is still so young; they shouldn't have to endure this!

The emergency department internal medicine doctor sighed, lowered their head, the indignant expression on their face faded away, and they entered the internal medicine consultation room with a blank face.

Zheng Ren knew, this is a kind of self-protection for doctors.

If one's feelings are too rich, working in a hospital for a year or two will drive a person crazy.

Here, there are too many joys and sorrows, too many helplessness, too many situations where one can do nothing.

He went out through the side door, took out a Purple Cloud from his white coat pocket, took out the half cigarette left from last time, and lit it.

The pungent tobacco smoke swirled around, then was blown away by the north wind.

If Big Pig Trotter's diagnosis were wrong, how good that would be.

If my own judgment were also wrong, how good that would be.

Unfortunately, Zheng Ren could instantly find similar case reports in his mind, at least a dozen or so.

What a pity.

A few minutes later, Zheng Ren finished his cigarette and went back inside.

He didn't go into the internal medicine consultation room, but sat on the red hard plastic chair outside, waiting for the results.

The weather was very cold, and the hard plastic chair was also very cold.

……

……

It's a pity, the chapter breaks here…… due to lack of writing strength; if I could change the break point, that would be better. I'll try harder next time.

Moreover, I woke up at 3 o'clock yesterday morning; why would there be a message at 3 o'clock from a reader wearing safety pants urging an update? The reader Late Autumn's Leaf then said, "Almost finished reading it again." In an instant, it was like receiving an emergency case, and I was jolted awake. Have I updated? Have I posted? No, I haven't. Why does Late Autumn's Leaf say they've finished reading it again?

Hmm…… crying.

Then I noticed it was almost finished reading again. Lately the pressure has been huge, a major climax is approaching (maybe late this month); as a doctor, I consider this a major climax, fearing that readers won't accept it, I've been writing with all my heart and mind every day. Feeling apprehensive, tense. Especially when looking at various charts, up and down are familiar titles; I can say I'm growing old watching their books, which makes me even more dazed.

I will double my efforts.