Chapter 1369: Factitious Disorder Imposed on Another (Munchausen Syndrome by Proxy?)

Chapter 1369: Chapter 1369: Factitious Disorder Imposed on Another (Munchausen Syndrome by Proxy?)

"Tsk tsk, Dr. Liu is really impressive, seriously too impressive, this moment clearly calls for applause."

When Liu Yiqing returned to the lobby on the first floor, Liu Banxia gave her a thumbs up.

Faced with Liu Banxia teasing her, Liu Yiqing was completely distressed. She had no idea where that burst of primordial strength came from, and then it just suddenly exploded for a moment.

"Teacher Liu, I suspect you did that on purpose, but I don’t have any proof yet." Liu Yiqing muttered.

"What would I be doing on purpose? Anyway, I think you basically managed it on your own. When the people from the superior department get here later, just help cooperate with them." Liu Banxia said.

"Sigh... honestly I really don’t want to do this job. I feel like even if I don’t say anything, under his parents’ persuasion he’d still provide it for everyone." Liu Yiqing said.

"If you put it that way, he’s not completely beyond saving, there’s still some chance. Teacher Liu, do you think his syphilis is likely to be malignant?"

"From a statistical standpoint, the chance of it being benign is only a bit over 30%, I think. We still have to wait for the pathology results to come out to know." Liu Banxia said.

"And right now we can’t do anything else anyway, we have to first give him a course of penicillin. You, you’re just too soft‑hearted in bursts."

"If he kept insisting, I definitely wouldn’t bother with him." Liu Yiqing forced herself to say.

That was just her personality. Like Liu Banxia said, she was too soft‑hearted.

Otherwise her brother and sister‑in‑law wouldn’t have bullied her to that extent, yet when they really come begging her for help, she still helps them.

Anyway, Liu Banxia felt that if it were him, he really couldn’t do it.

"Director Liu, are you busy?" At this moment Chen Hongyang walked over.

"Not busy, nothing much going on these last couple of days, I’ve just been studying pediatric general surgery." Liu Banxia said.

"I’ve got a little situation here, come over and help me judge it." Chen Hongyang said.

Liu Banxia nodded.

This wasn’t a big deal, it was perfectly normal; he also called on Chen Hongyang for consults.

It was just that once he followed Chen Hongyang into the pediatrics office, he felt something was off. Shouldn’t they be out front looking over the patient’s information?

"Hold on a second, this little patient’s case is a bit special."

Chen Hongyang started working at the computer.

Liu Banxia craned his neck to take a look; what Chen Hongyang pulled up was the chart of a 4‑year‑old patient.

"This kid is pretty frail. From last year till now, he’s basically been coming to our emergency center about once a month. Bronchiectasis, spasms, seizures—what disease does he have?"

After looking, Liu Banxia asked.

Chen Hongyang sank back into his chair. "This is exactly the kind of case that gives me a headache. He’s here again this time, again with some breathing difficulty, accompanied by seizures, so we started with oxygen."

"According to the child’s mother, he’s a preterm baby, so his constitution is weak from birth, with respiratory distress syndrome and abnormal bronchial development."

At this point, Chen Hongyang paused.

"There’s definitely something else going on. If it were just abnormal bronchial development, you wouldn’t be calling me over." Liu Banxia said.

"Even though I’m currently studying pediatric general surgery, this doesn’t really fall in my domain either. Besides, no matter how good I am, this doesn’t make sense—you should be calling Xu Hui and Wang Huan."

"Take a look at what I’ve jotted down on the side."

Chen Hongyang opened a folder, pulled out a sheet of paper from inside, and handed it to Liu Banxia.

With just one glance, Liu Banxia’s brows knitted tightly together.

On that sheet were records of the same little patient’s visits to Third Hospital, First Hospital, and the Municipal Hospital. It covered from the child’s birth to now, written densely line by line.

Although the intervals between visits to each hospital were somewhat large, if you merged all the records from all the hospitals together, basically it worked out to at least once a month.

At most, there were two visits in one month.

"You see it, right? I just made a round of calls and contacted everyone I could." Chen Hongyang said.

"Under normal circumstances, this kind of information shouldn’t be shared externally. But this situation is special, it’s a bit of a violation of the rules."

"A good violation. Isn’t this a textbook case of Munchausen syndrome by proxy?" Liu Banxia asked.

The condition he mentioned is actually one manifestation within a group of related disorders.

Munchausen syndrome by proxy is when a caregiver deliberately exaggerates or fabricates certain conditions of the person they’re caring for, and then repeatedly brings them for medical treatment.

And don’t think this is just a trivial psychological issue; once this kind of psychiatric disorder gets severe, they may even poison the cared‑for person’s food.

The most classic example happened in the UK: a pediatric nurse dubbed the "Angel of Death" injected patients with potassium chloride, causing the deaths of four children and harming at least five victims.

The corresponding condition is Munchausen syndrome, also called "hospital addiction." It’s the counterpart of the proxy type—if they’re not harming others, they’re harming themselves.

And among patients with Munchausen syndrome by proxy, most of them tend to be mothers.

They’re immersed in the state of caring for a sick child and can’t pull themselves out of it.

Put simply, it’s when your mom thinks you’re sick. If there’s medicine to take, you take it; if there’s treatment to do, you do it—this can’t be stopped.

If we’re looking for a recent example, there is one: that young couple Liu Banxia saw in clinic.

The girlfriend likes being sick, because she can enjoy her boyfriend’s meticulous care. The boyfriend also kind of likes his girlfriend being sick, because it means he gets to take care of her again.

They were still only in the early stage of this, their mutual feelings already a bit distorted. After Liu Banxia noticed it, she gave them appropriate psychological guidance and helped them realize what was going on.

In the end she referred them to psychological counselor Tian Yu, and now there really isn’t any problem anymore. So that young man is very grateful to Liu Banxia; otherwise he wouldn’t be sending patients her way.

Now this little kid’s situation is already showing some signs of Munchausen syndrome by proxy. Even if his physical condition is a bit poor, this kind of frequent hospital visits is still abnormal.

The key thing is, they’re even rotating between different hospitals.

That means the parent who brings him in already has a certain "danger awareness," knows something about this is off and that the doctors mustn’t find out.

"Is it the mother who brings the child in?" Liu Banxia asked.

Chen Hongyang nodded. "That’s why I’m feeling unsure now. For this kind of thing I need you to help me make a call."

Liu Banxia scratched her head a bit; this could end up being a big thing or a small thing.

If the kid actually has some complicated disease that just hasn’t been diagnosed yet, then frequent hospital visits are also possible.

Because once we make a judgment on our side, the child’s mother will be facing a very complex, very difficult situation.

Ding! Mission published: Is it Munchausen syndrome by proxy?

Open mission: At the request of Chen Hongyang for a joint consultation, you discover that the child’s mother is taking the child in and out of hospitals frequently, which draws the host’s attention. The host must determine whether the child’s mother has Munchausen syndrome by proxy. Mission reward: to be issued based on diagnostic result.

Liu Banxia scratched her head again; she hadn’t expected this matter to trigger a mission.

By now she’d noticed a general pattern for mission triggers: when she doesn’t have a solid grasp of a condition, or when there are two opposing lines of thought and she’s hesitating, that’s when the system loves to issue missions.

Of course, she couldn’t exploit this discovery to farm missions; there’s no way to cheat it.

Her thoughts are straightforward, that’s one continuous line of thinking. If she could manage to trick herself, that’d be pretty impressive.

"What’s your take?"

Seeing Liu Banxia stay silent, Chen Hongyang added a sentence.

"It’s hard to have any kind of ’take’ on this. We have to be extremely cautious. At the lighter end it can wreck the family’s harmony; at the heavier end, who knows what might happen." Liu Banxia said with a wry smile.

"Because if this gets firmly confirmed, it’s basically abuse, isn’t it? Who else in the family would be doing it? Especially the child’s father—this won’t be easy to handle."

"Yeah... that’s exactly what I was worried about, which is why I called you over." Chen Hongyang said.

"I remember you’ve diagnosed something similar before, right? That female patient who pretended to faint after a fall, she kind of had this tendency, didn’t she?"

"I just thought of that young couple too, but their situation is still different from this. This kid is only four; he can’t even express himself properly." Liu Banxia said.

"Last time I talked with each of them separately, and her boyfriend already had some sense that something was off, that’s how we found it. But this... what do we do here? The kid can’t explain anything."

"How do you find the child himself? You’ve already seen him three times. How does his body present? I think you should have at least a basic sense of that by now."

"To be honest, the child was indeed born premature, and he stayed in the incubator for quite a long time. He’s much more frail than a normal child." Chen Hongyang said.

"That’s also why his frequent hospital visits haven’t drawn too much attention. It’s just that recently she’s fixed her eye on our emergency center. We don’t have many pediatricians here, so it left an impression on me."

Liu Banxia nodded. This really was a tricky problem.

"And if we want to report this, I actually don’t have that authority. You’re a deputy director and I’m just a junior doctor, right?" Chen Hongyang said.

Liu Banxia rolled her eyes. "Is this annoying or what? Still holding a grudge? Our blow-up, that was ages ago."

"Hey... I’m just rattled. I care about the kid." Chen Hongyang sighed.

"At this point I don’t even have the心思 to see the kids waiting after him. If we don’t get this figured out, it’s going to keep nagging at me. Even when I’m treating other children, this case is what I’m thinking about."

Liu Banxia patted his shoulder; that was the only comfort she could offer.

Pediatric patients tug at people’s hearts the most. With things still murky like this, of course it would weigh on Chen Hongyang.

This is entirely different from just not being able to make a diagnosis.