307 Neuropsychiatric-based Dermatological Disorder 2in1

    "Help, it's so itchy... There are many worms crawling inside my face..." Inside the quarantine room, Xie Yiman paced around in pain. She'd bury her head deep into the pillows or pinch her arms heavily but eventually she'd return to scratching her face. Her face was now filled with scars. Suddenly she slammed her head against the wall and the attending nurses quickly rushed in to stop her. Beneath the halo of celebrity, she was just an 18-year-old girl and she started to weep. The live feed of the situation inside the quarantine room was wired to a conference room inside the hospital through the cameras. Uncle Dan, Gu Jun, Zhang Donghai and the other doctors frowned as they watched the development on screen, it was clear that Xie Yiman's mental state was worsening.

    "The patient has shown increased signs of self-mutilation, we need to post more caretakers to watch over her." Zhang Haidong said.

    "Prof Zhang, if we strap the patients into place," Gu Jun asked, "Will it worsen their mental stability?"

    What was the cause? Since they had no answer, there was not much they could do. If this was a dermatological illness, it was not from a virus, bacteria or parasite, it was not an allergy or a skin tumor... X-ray imaging and vital signs of the victims gave nothing valuable either. Local anaesthesia could not stop the itching. Combining all these factors, all the doctors across the country reached the consensus that this was more like a 'neuropsychiatric-based dermatological disorder.'

    Gu Jun was afraid that was the case because once it was defined as a neuropsychiatric illness, the treatment would be extraordinarily hard. If it was caused by a bacterium, then they would only need to kill the bacteria, but things were different if it was a psychiatric illness. In modern age, psychiatric disorders were surprisingly common due to the amount of stress people suffered from daily life. It was why over the counter antidepressants was such a million dollar industry.

    In fact, there was an actual psychiatric disorder called fictitious dermatitis that bore resemblance to Xie Yiman's conditions. The patients would complain of parasites in their bodies even though all the testing had shown that there was nothing. They refused to believe in the results and insisted on the presence of parasites. Nail biting and minor self-mutilation was a common manifestation of this illness. If not for the brand-like rashes on the patient's faces and their similarity in career background, this could be easily misconstrued as fictitious dermatitis.

    "Immobilizing the patient will worsen her mental state." Zhang Haidong said sternly, "Ah Jun, I think you need to go talk to the patient, after all, she has formed a bond with you."

    "If nothing works, shall we try induced coma?" Uncle Dan gave a suggestion that was on everyone's mind. Induced coma was mainly used to treat concussion victims. But sometimes a deep anaesthesia was necessary to immobilize certain patients.

    "Let me try talking to her first." Gu Jun said. Neuropsychiatric disorder referred to either abnormality in the neurological function or mental disturbance, this case leaned towards the latter because local anaesthesia proved futile. Then the key treatment method here would have to focus on how to correct and adjust the patient's mental status.

    "To cure this kind of illness, one normally needs to find a trigger." Zhang Haidong offered. With decades of experience in the dermatological department, he was the leading expert at Phecda. "Such patients have an abnormal mentality, there is a trigger of sorts in their mind. Once it's switched off, the itching will stop. So one has to convince them that the treatment is effective, then the trigger will be switched off. But that in itself is a circular activity, it is why this illness is so hard to treat."

    How to stop the itchiness was the main problem. For normal neuropsychiatric-based dermatological disorders, some medicine would have relative relieving effects. Patients with light syndrome would even react positively to lotion being applied on the affected area. If anti-inflammation and anti-itching medicine did not work, then the doctor would prescribe anti-depressant and sedative before finally applying local anaesthesia. In Xie Yiman's case, they had reached the anaesthetic step by prescribing her the procaine block therapy. Local anaesthesia was applied to lower the sense of itchiness or pain and with psychiatric treatment, one would head towards recovery. But due to supernatural influence, none of these methods worked. Theoretically speaking, Xie Yiman should not be able to feel her face anymore but she claimed constant itchiness from crawling of worms. Gu Jun even applied the golden aloe but it was also useless. Perhaps a live aloe would be effective but they still had not figured out a way to transport that out from the Dreamlands. According to Lucky's latest report, there was no new activity at the House of Worm and there was no sight of any new channel either.

    "I'll go talk to her." After the meeting ended, Gu Jun returned to the quarantine room. Currently all the patients were kept at local hospitals, Phecda was still considering the logistics of moving all the patients. That needed more time to confirm and plan. But the patients could not wait anymore.

    "Captain Gu, save me!" When Xie Yiman saw him, she flew to grab at his protective suit and pleaded, "Please save me..." Gu Jun took a deep breath. Whenever he heard these please, his heart would tear. Temporary, the most serious patient of this new illness was Xie Yiman. The rash on her face did not expand but the itchiness was close to breaking down her mind.

    "Yiman, we have grasped the basic situation already. The suit is just part of the procedure, your illness is not contagious. It is not caused by bacteria or virus, instead your mind is being influenced by some kind of supernatural forces." Gu Jun patted Xie Yiman's shoulder and gently explained to her the concept of neuropsychiatric-based dermatological disorder. He took special care not to trigger anything in her. Prof Zhang warned him of the mental instability in such patients, they got anxious very easily. Claims like 'you are not sick, it's just something wrong with your mind' would not sit well with them. After years in clinical treatment, one'd learn how to interact with patients. Respect and empathy towards patients were extremely important. Therefore, when Gu Jun chatted with Xie Yiman, he was careful to not paint her as a crazy person but as a victim.

    "That kind of force formed a mental connection with you and it poured negative stimuli into your brain, making you believe that there is itchiness on your face and it will not go away no matter how hard you scratch at it. But if we sever this connection, the itchiness will go away." Gu Jun was not just speculating, that was how they cured Nightmare Illness.

    "Then... then what should I do now?" Xie Yiman was confused and anxious but she had trust in Gu Jun.

    "We will increase the dosage of sedative in you and affix you to the bed. Your limbs will be tied and all you need to do is to focus your consciousness and resist!" Gu Jun encouraged. "Ignore the itchiness and we will see what will happen tomorrow!" To have the patient face the connection and resist it head on might be able to disrupt the mental connection.

    "No, no, no..." Once she heard that, Xie Yiman panicked. She screamed with tears. "If that's the case, I'd die! Captain Gu, it's not that I don't want to resist but I can't! Do you understand me? I can't, I can't do it..." Seeing her agitated emotion, Gu Jun knew this method would not work because the focus of the treatment was not on the sedative but on the patient's mental resistance and strength.

    "Captain Gu, if you wish me death." Xie Yiman suddenly said, "Then I'd rather die now than later!" She turned to ram her head against the wall, Gu Jun immediately pulled her back. "Don't! We have other treatment methods, if this does not sound good to you, we can try another one. Don't give up so soon."

    "What other method?" Xie Yiman asked between breaths. She scratched her face violently as hope relit her eyes.

    "Induced coma." Gu Jun said, that was the final solution. "We will perform a full body anaesthesia for you to go into a coma so you won't be able to feel anything."

    "That's perfect!" Xie Yiman nodded with joy. "This is good, I've been yearning to sleep. This is perfect!"

    "But there's a risk that you might not be able to wake up anymore." Gu Jun had the responsibility to tell her that. Normally, if a doctor wanted to wake a patient from an induced coma, they would lower the dosage and perform physical movement like shaking the patient but there was no telling what would happen in this case. Gu Jun personally was against induced coma because of this risk. Furthermore, who knew what would happen when the patient lost full consciousness, would their condition exacerbate?

    However, if they did not take any measure soon, the itchiness would drive the patients insane. Facing a new illness, every treatment method had to be tried and someone had to volunteer to be the white mice.

    "I..." Xie Yiman was stunned, there was a chance that she would not wake up? "Then can I call my parents first?"

    "Sure." Gu Jun abided by her request. This was not a problem because her family had been brought under Phecda's protection. Xie Yiman had a long chat with her parents. She choked on her words several times, no one expected her to go through a risk like this. But less than an hour later, due to the increased itchiness, she decided to go for the trial. At that point, she only wanted to rest...

    Once the method was decided, it was quickly executed. Various devices were moved into the quarantine room. The team of anaesthetists was ready and they decided to give Xie Yiman a respiratory anaesthetic. This famous celebrity slowly closed her eyes in pain and anticipation. At 2 pm, Xie Yiman was the first to accept an induced coma as a responsive treatment to this new illness.

    After she went out like a light, her condition was closely monitored. Gu Jun, Deng Ximei and Uncle Dan guarded beside her bed with the team of anaesthetists, watching her quietly...

    From the start, Gu Jun was against induced coma and as he studied Xie Yiman's ruined face, the ominous feeling within him grew. Half an hour after the induced coma, while Xie Yiman remained motionless in bed, the devices next to her started to beep. Encephalography for conscious and unconscious individuals was completely different. The encephalogram showed that Xie Yiman's brain activity was resuscitating but in real life, the girl was still unmoving.

    "Wake up the patient now!" Gu Jun said urgently and took a deep breath. The team of anaesthetists moved into action. Uncle Dan gritted his teeth in regret. "Damn it, I should not have suggested this, this is all my fault..."

    "Uncle Dan, at the time, we had to try something." Gu Jun knew this was no one's fault. Uncle Dan had the patient's best interest in heart.

    Suddenly, Deng Ximei whispered to him, "Perhaps, this is the opportunity for us... to see what Xie Yiman is currently experiencing ourselves?"


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