Listening to her description, Su Xuezhen already had a vague diagnosis in mind—enuresis.
This primarily refers to the clinical symptom of involuntary urination during sleep in children older than five. It’s most common in children under ten, with boys being more frequently affected than girls. The incidence decreases with age, but in a small number of cases, it can persist into adulthood. Early detection and treatment are not difficult. The real problem lies in its psychological and social impact on the child—it can easily lead to low self-esteem, introverted personality traits, and even family conflicts.
Seeing the hopeful look in Yu Sibei’s eyes, Su Xuezhen slowly opened her mouth.
“Junfei’s mom, don’t worry. Let’s take things step by step.”
Yu Sibei gradually calmed down.
Su Xuezhen pulled a picture book from the reading corner specially set up for children and slowly walked over to Li Junfei, crouching down to hand it to him.
“Junfei, would you like to look at a book over there for a while? The doctor auntie has a few questions to ask your mom, and it might take a little time.”
Only then did Li Junfei timidly lift his head to look at her. He reached out his little hand to take the book and let her lead him to the reading corner to sit down.
The bench wasn’t high; his feet could just touch the floor when seated. On the table were some colorful origami papers and various paper animals—some strange, some beautiful. It seemed like they weren’t all folded by the same person. He carefully picked up one of the paper cranes and secretly glanced at Su Xuezhen and his mother from the corner of his eye, his gaze cautious.
Neither of them paid him any attention. Even his usually overly watchful mom wasn’t looking at him now. Instead, she was chatting with the pretty doctor auntie. That made Li Junfei feel much more relaxed. He tossed the book aside and started playing with the origami.
Su Xuezhen took out a pen and began recording while asking questions.
“How old is Junfei?”
“Six and a half.”
“Is there any family history of enuresis?”
“Heavens, how would I know that?”
“When does the bedwetting usually occur—during the day or night? Or both?”
Yu Sibei thought for a moment. “It mostly happens at night when he’s asleep.”
“Does he usually drink a lot of water? How frequently does he urinate?”
“How would we know if it’s a lot? If he’s thirsty, we let him drink. If he wants to pee, he just goes.”
“Have you ever observed his urinating posture?”
“His posture is definitely fine. We’ve taught him many times. He knows how to pee properly.”
“Has he shown signs of frequent urination? Or continuous dribbling, interrupted flow, or a weak stream?”
“The way you’re asking—what, are we supposed to stand there and watch him pee every time? Wouldn’t that make it even harder for him to go?”
“How about his bowel movements? Any signs of constipation or fecal incontinence?”
“No, that part’s normal. He poops just fine.”
What kind of ridiculous questions were these? Weren’t they here to treat bedwetting? Why was she asking about his poop too? Yu Sibei was starting to get annoyed and pressed her:
“Dr. Su, can’t you just tell us how to treat it already?”
Su Xuezhen’s expression turned serious.
“Junfei’s mom, please answer every one of my questions truthfully. Don’t be careless or dismissive. I’m not making idle conversation with you for no reason.”
Yu Sibei awkwardly replied, “Please continue asking.”
“Has he always had the habit of bedwetting since birth? Was there ever a period when it stopped?”
Thinking for a moment, she said, “Now that I recall, there was a time when it stopped for over half a year.”
A break of more than six months indicated that there likely weren’t major issues with neurological development or bladder function. This pointed toward secondary enuresis. Su Xuezhen quickly jotted it down and asked further, “Did anything particular happen during that time?”
“Back then, we found a folk remedy in the countryside and burned some incense in the room. It felt like it worked. He didn’t wet the bed for over half a year. But later, for some reason, it started again, and the incense stopped working.”
Su Xuezhen paused briefly as she held her pen, then said gently, “This isn’t something that can be resolved by folk remedies.”
Afterward, she asked about his sleep and daily activity habits. Finally, the questioning reached its last stage. Su Xuezhen slowly put down her pen.
“When he wets the bed, do you punish him?”
Yu Sibei confidently denied it, “We only have this one son. We spoil him enough as it is—why would we hit him?”
“Punishment isn’t limited to physical discipline.”
Su Xuezhen shook her head. “Please answer honestly. This is very important.”
“There were a few times when his dad just couldn’t take it anymore and made him sleep beside the bathroom for a few days.”
Yu Sibei quickly added, “It was really just those few times. We were at our wits’ end and thought maybe it’d help him remember to go to the toilet when he needed to pee.”
“You work too, so you understand how exhausting it is. We can’t even sleep at night, constantly changing his sheets—it really gets frustrating.”
These days, bathrooms are usually built behind the house, and making a child sleep nearby is practically the same as kicking them out. A slightly more stubborn child might even run away from home. Su Xuezhen found it hard to imagine that someone would treat their own child like this. Her expression turned stern. Fearing she’d scare the child, she lowered her voice.
“That’s child abuse.”
Li Junfei glanced over, then quickly looked away and continued folding origami.
In the heat of the moment, they hadn’t thought it through. Yu Sibei had regretted it afterward. Now, faced with Su Xuezhen’s accusation, she looked even more ashamed.
“We won’t do it again, really. Can it be cured?”
“We’ve only done an initial history-taking through these questions. We still need to conduct further tests to determine the cause and develop a treatment plan.”
Parental reports aren’t always fully accurate, so this stage only helps form a general picture. A proper diagnosis requires a series of follow-up tests. Su Xuezhen couldn’t draw conclusions lightly.
“I’ll call in a nurse shortly to perform a basic physical and developmental assessment on Junfei to check for any organic causes. We’ll also do a urinalysis, a urinary system ultrasound, and an assessment of bladder functional capacity.”
Yu Sibei kept nodding as she listened.
Su Xuezhen turned around to look at Li Junfei and saw that the small desk was already covered in paper cranes.
She smiled and asked, “Wow, amazing! Did you fold all of these?”
Li Junfei bashfully nodded.
“I’ll need to do a physical check on you soon. Will you cooperate with me? It’ll be quick and won’t hurt.”
Knowing she might be able to fix his bedwetting problem, Li Junfei immediately stood up. Su Xuezhen smiled and patted his head before going out to call in Lu Ziyue.
The two of them worked together efficiently, and the basic examination was done quickly. Most importantly, there were no issues with his abdomen, nervous system, or urogenital system.
As of now, Li Junfei appeared to have secondary monosymptomatic nocturnal enuresis. Su Xuezhen filled out the test orders and instructed them to complete all the tests today.
If the remaining results also came back normal, there would be no need for surgery. Simple behavioral therapy and arousal training could produce good results. The real challenge lay in addressing the psychological side, which required the combined efforts of parents, doctors, and the child.
Seeing that the examination was done, Yu Sibei quickly expressed her thanks. Su Xuezhen added:
“Finish the tests today. The reports will likely be ready tomorrow. Come back the day after. No need to bring the whole family again.”
“This isn’t some rare or hard-to-treat illness. Don’t be too harsh on the child—be patient, encourage him appropriately. Children are very sensitive. If you get anxious, he’ll feel anxious too. The more anxious he gets, the more nervous he’ll become.”
“Make sure he gets enough fluids during the day, but don’t let him drink anything within two hours before bedtime. Encourage him to gradually increase the interval between urination during the day. If he normally pees every two hours, try to stretch it to three—but don’t force him if he really can’t hold it. Take it step by step. Set an alarm and wake him up to go to the bathroom before his usual bedwetting time at night. You’ll start seeing results in as little as two weeks.”
That phrase—“start seeing results”—was like a drop of sweet rain to this withered, near-collapsing family. It brought them a renewed sense of hope. Yu Sibei thanked her repeatedly, saying, “Yes, yes, yes—we’ll do just that, don’t worry.”
Su Xuezhen reminded her, “Remember to come back the day after tomorrow.”
Yu Sibei nodded. After speaking, she took the test orders and led Lin Junfei out. The family chatted outside for a while. Their cheerful voices could be heard from inside the room. Exhausted, Su Xuezhen slumped into a chair and took a few big gulps of water.
Lu Ziyue came by and knocked on her door. “Dr. Su, come out and grab a bite. It’s already one in the afternoon. Sister Juan had someone bring lunch for us.”
“So late already? One o’clock!”
Su Xuezhen checked the time—sure enough, it was. She replied with a quick “Okay” and got up right away.
Wei Juan had already eaten. At this point, only she and Lu Ziyue hadn’t eaten yet. Su Xuezhen opened the door to the side break room. The two of them sat on chairs, holding their lunchboxes, and finally started their long-overdue lunch.
It was braised noodles with green beans and shredded pork—probably a batch that had stuck to the bottom of the pot, giving it a slightly charred taste, but it was really fragrant. After finishing their meal, it was already time to get back to work. The afternoon rounds were next, followed by preparation for the cystic lymphangioma surgery scheduled for tomorrow. Not a single moment to rest.
It wasn’t a procedure Su Xuezhen could perform on her own—Director Ling Yurong had to assist as the primary surgeon for the operation to proceed. Just as she was wondering when the director would arrive, she returned from the rounds and saw that Ling Yurong’s office light was on.
Su Xuezhen headed straight over, her voice noticeably louder:
“Teacher?”
Ling Yurong set down her teacup when she heard the voice, looked up, and gave her a warm smile. “Just finished rounds?”
Su Xuezhen gave a hum of acknowledgment and walked over to his desk.
Ling Yurong was an authority in pediatrics, especially skilled in pediatric cardiovascular and cerebrovascular diseases, difficult-to-treat pediatric nephropathy, and chronic nephritis. She was a top-level figure in the country, and studying under her had been immensely beneficial.
Ling Yurong sighed, “I attended a meeting at the hospital. This year, it looks like the pediatrics department will only get two doctors. In the future, I’m afraid you’ll still have to work hard.”
Whether it was her imagination or not, Su Xuezhen felt that the teacher seemed a bit older after this trip. The hospital’s decisions were beyond their control. With no other choice, she could only sigh, “It can’t be helped.”
“I heard from Wei Juan that you’re pregnant?”
The news of her pregnancy spreading like this made Su Xuezhen a little unhappy, but since the teacher had asked, she couldn’t avoid answering. She hurriedly replied, “Yes, almost six weeks along.”
With pediatrics declining and new talent scarce, it was incredibly difficult to find a promising successor. Ling Yurong had observed Su Xuezhen for over a year and knew she was diligent and attentive. She had originally planned to groom her as her successor after this training, but then Su Xuezhen hit her with a surprise—she was pregnant.
This threw Ling Yurong into hesitation.
