Chapter 17: This is a bit difficult, isn't it? (1)

Hematology.

Also known as the Department of Hematology and Oncology.

At first, it was just one of many departments.

But now, it has become a department whose importance is growing throughout the entire internal medicine field.

It was only natural, given that cancer has become the most critical issue in modern medicine.

"The patients who are admitted for chemotherapy cycles... if the medication is administered properly, there's not much to worry about. Of course, if complications arise, it's a big deal, but Professor Cho Taejin has done a lot of research in this area, so you don't need to worry too much."

Chief Resident Kim In-sung, while scanning through the patient list, began to speak.

Suhyeok, standing behind him, merely nodded.

[Why should I listen to something I already know?]

Baruda, unable to hold back, started to challenge Suhyeok.

'You idiot, are you telling me to tell a third-year resident to back off?'

Suhyeok responded to Baruda, who still didn't consider human hierarchies or ranks.

[If you soften the tone, I might listen. What should I do?]

'No... Absolutely don't.'

In fact, Suhyeok didn't nod to everything Baruda said.

Just having a conversation with Baruda, who talked incessantly, was already a significant mental drain.

"Patients who come in during chemotherapy... there are issues with immune deficiency, side effects from chemotherapy, and even cases of recurrence. Some have metastasis."

"Yes, sir."

"Currently admitted patients have a plan in place, so it should be fine..."

Kim In-sung scrolled down.

There were 21 patients admitted under Professor Cho Taejin, and 17 of them were not in the ICU.

He intended to hand over 7 of these patients to Suhyeok, a gesture filled with royal treatment.

These were patients who mostly required only repeat prescriptions.

[They're all too easy. I won't get any practice.]

'Hmm... You're right.'

It was quite blatant. The feeling that he was only given easy patients was strong.

Even Suhyeok, who wanted to make things as easy as possible, felt a bit dissatisfied.

While he didn't want to 'practice' with patients as Baruda suggested, seeing difficult cases would certainly help him learn.

It wasn't for nothing that professors often said, "The best teacher is the patient."

"The patients who come through the emergency room will be more difficult."

But patients would continue to be admitted through the emergency room or outpatient clinic.

And finding the cause of their fever or other symptoms would be extremely difficult.

Kim In-sung, with a worried look, gazed at Suhyeok, whom he considered the most royal resident since his arrival.

'From April in hematology... it's quite intense... Should I have suggested changing the schedule?'

Of course, Suhyeok was thinking something entirely different.

So was Baruda.

[It's my turn for duty today. I hope a difficult patient comes.]

'Huh...'

[Why are you saying that?]

'It's just... strange... to hope for that...'

How did his mental state deteriorate to this point?

All the other first-year residents hoped no patients would come during their duty.

Anyone who heard this would call him crazy.

'No, it's not that bad. If this gets out, I'll really be in trouble...'

[It won't come to that.]

'What do you know?'

[Thanks to someone, I got 100 days off duty.]

'Ah, right. That... is true.'

100 days of duty.

It wasn't a custom exclusive to internal medicine.

Most departments maintained the tradition of not letting first-year residents leave the hospital for the first 100 days.

The reason was that they might get a taste of the outside world and want to run away.

'Well, the 100-day duty was supposed to be abolished due to the 88-hour workweek for residents...'

[But everyone is still grateful.]

'That's a relief.'

Not absolutely, but reputation was always important.

Especially the reputation among peers, which was often the most accurate, was trusted by many organizations.

"Anyway, for the currently admitted patients, just repeat the prescriptions or follow the routine prescriptions. If you have any questions... hmm."

Kim In-sung was about to tell him to call him, but then remembered what Professor Cho Taejin said this morning.

- He's so smart. I want to see for myself. Let's see if it's true.

Internal medicine professors were more scholarly than those in other departments.

If it were surgery, he would have just handed everything over to a third-year resident.

But he wanted to check for himself.

"Ask me about prescriptions. If you need to notify a patient from the emergency room... do it directly to Professor Cho Taejin."

"Really? Is that okay?"

"We did it that way during the infection outbreak."

"That was..."

"It's Professor Cho's instruction. Do it that way."

"Ah, I understand. Thank you, sir."

"Don't mention it. I'm off... have a peaceful night."

Kim In-sung trudged into the third-year resident's duty room next to the office.

[Your shoulders are drooping. You might have a forward head posture.]

Baruda, as usual, quickly diagnosed.

Suhyeok slowly shook his head.

'Not that. He probably hasn't published a paper yet.'

[Papers?]

'You need to be the first author on at least one paper to become a specialist. But he hasn't met the journal's revision requirements yet.'

[Hmm.]

Baruda swallowed in silence.

But Suhyeok felt his heart racing at Baruda's ominous words.

'Every time he makes that sound, something bad happens...'

[We need to find a research topic soon.]

'It's April for a first-year resident...'

[If you dilly-dally, you'll be a third-year resident before you know it.]

'Don't be ridiculous... Ah.'

Suhyeok, about to continue the verbal sparring with Baruda, started rummaging through his gown pocket.

Buzz.

The phone, set to vibrate during the chief's rounds, was ringing fiercely.

'3777...'

The emergency room.

He had hoped for a patient, but not for the chief to call right after leaving.

Did he pray too hard?

[Answer quickly.]

Of course, Suhyeok couldn't be lost in thought for long.

Baruda was urging him to answer the phone.

"Yes, this is first-year resident Suhyeok from Internal Medicine."

"Ah, sir. I'm calling about a 52-year-old male patient who received chemotherapy and radiation treatment for nasopharyngeal cancer at our hospital three months ago."

Nasopharyngeal cancer.

Cancer that occurs in the nasopharynx, the area behind the nose.

It usually responds well to chemotherapy and radiation treatment without surgery.

Suhyeok nodded and quickened his pace.

"What brought him in?"

"He... came in with sudden onset of quadriplegia."

"Quadriplegia?"

Nasopharyngeal cancer can cause various symptoms, from nosebleeds to headaches and pain.

But quadriplegia?

That was an unexpected symptom.

Sensing the confusion in Suhyeok's voice, the intern continued urgently.

"We notified neurology to rule out any brain issues, and they are currently conducting an examination."

"Ah... So you want us to confirm since he's a patient of our department?"

"Yes, that's right."

"Okay, I'll come down."

It didn't seem to be as difficult a case as he had hoped.

Neurology would likely conduct various tests, take an MRI, and admit the patient to their department.

He would see the patient in a consultative role.

With this in mind, Suhyeok headed down to the first floor and then to the emergency room.

Baruda, who shared a similar opinion, didn't say much.

"Where is the patient?"

Suhyeok asked, and the intern, who had just called him, pointed down the corridor.

A bed being moved by a transport staff toward the MRI room was visible.

A thin patient lay on the bed.

"Ah, thanks."

Suhyeok said and hurried to catch up with the bed.

But it wasn't easy.

Thud.

Thud.

He wasn't used to using a cane, so it was inevitable.

Suhyeok only reached the MRI room after the patient had already entered the examination room.

Fortunately, he was now a resident, not an intern.

So he could enter the imaging room without much interference.

"Ah, internal medicine doctor?"

A neurology resident, who had come down earlier, was inside.

Suhyeok had never seen him before, probably from a different school.

"Yes, sir."

"Actually, I told the intern not to call, but... it's April... don't be too upset."

"No, I'm not. You seem to be confident it's a brain issue?"

"Yes. The examination shows clear weakness and sensory loss in the limbs. The onset was very sudden... it's unlikely to be a hematoma."

"I see."

"However, it's a bit strange that the patient is conscious... but it could happen."

In the case of a widespread stroke or hemorrhage, quadriplegia, or full-body paralysis, can occur.

'If it happened suddenly, that would make sense.'

[That's my thought too. We need to confirm the test results.]

'Right... here they come.'

The images from the MRI scan started to transfer to the radiologist's station in real-time.

Both the neurology resident and Suhyeok turned their heads toward the monitor.

And almost simultaneously, they tilted their heads in confusion.

"That's strange?"

"There's nothing there?"

The brain images that were transmitted were completely normal.

'Damn, what is this?'

[Analyzing, please wait.]