Chapter 23: This is Confusing (3)

“Ugh... Good morning, Suhyuk. Did you sleep well?”

Thanks to a good first-year resident, Chief Resident Kim In-soo came out after a good night’s sleep and greeted with a smile.

It was truly a warm and kind smile.

When the nurses in the ward saw this, they started to murmur.

While they seemed to let Suhyuk’s muttering to himself pass as a ‘habit,’

Kim In-soo’s warm demeanor, which they had never seen in three years of working together, seemed too difficult to overlook.

“What’s going on? You can even smile.”

“Wow... Are you really that picky?”

“Dr. Hwang Sun-woo would cry if he saw this, he would.”

“But Dr. Hwang is a bit...”

“Anyway!”

Kim In-soo smiled again at the nurses’ familiar scolding.

“It’s because I’m in my third year. I feel like my heart is broadening. The hospital looks beautiful now, you know?”

“Well... First-year residents who were like devils become angels in their third year. Of course, some remain devils.”

There’s a saying that where there’s a barn, there’s generosity.

The analogy might seem a bit strange,

but if you feel comfortable yourself, you can be generous to others, right?

The situation the nurse just described wasn’t particularly rare.

First-year residents often live inhumanely, after all.

The moment they escape that, significant improvements in their character are not uncommon.

Of course, there are those who become even worse once they gain power.

“Anyway, is everything okay with the patients?”

Kim In-soo smiled a bit more and then turned his head toward Suhyuk.

It was a face that exuded deep trust.

“Yes, sir. The patient who was admitted yesterday slept well and had no issues during rounds. However...”

“However? What is it?”

Kim Jin-yong glanced at the clock behind Suhyuk.

The clock already pointed to 8:00.

It meant Professor Cho Tae-jin would be arriving soon.

‘Did something happen?’

Naturally, Kim In-soo’s heart began to feel uneasy.

Originally, the chief resident’s rounds should have been around 7:00.

Especially when a first-year resident is the primary doctor, it’s common to start even earlier.

They had to make up for any trouble they caused overnight.

‘Ah... I should have come earlier... Did I trust too much?’

But Suhyuk, being a first-year resident who handled patients more skillfully than a second-year,

had made Kim In-soo feel at ease for a long time.

So, with the intention of arriving before the professor, he came to work,

but hearing the word ‘however’ made him tense up.

“That... Patient Park Sang-a.”

“Oh, hurry up. The professor will be here soon.”

“I thought it might not be a metastasis.”

“What? What are you talking about, man! That’s the professor’s opinion. And the imaging shows...”

Kim In-soo wanted to argue more, louder, and longer.

Even if it bothered him to yell at a first-year, he wanted to do it.

But he couldn’t and had to close his mouth.

“Why are you so noisy?”

It was because Professor Cho Tae-jin had already approached.

It seemed he had a busy day yesterday, as today he only had research time and no outpatient clinic.

His hair was still a bit messy, and there was a faint smell of alcohol from his breath.

“That... That’s, I... Um...”

Kim In-soo wanted to say something right away,

but he couldn’t find the right words.

He thought, ‘This is when you become a mute who’s eaten honey.’

Meanwhile, Professor Cho Tae-jin spoke again,

with a face that seemed to find it very amusing.

“I actually heard. You think Patient Park Sang-a might not have a metastasis?”

Saying this, he plopped down into a chair, almost diving into it.

Since he had time and was probably tired from drinking last night,

he seemed determined to have a thorough conversation.

“Why do you think that?”

Professor Cho Tae-jin, like any other internal medicine professor, asked with a face that showed genuine interest.

If he were in surgery, he might have thrown something, claiming that his opinion was being ignored.

But internal medicine was indeed more dignified.

Of course, there were those who harbored resentment and sought revenge later.

Fortunately, Professor Cho Tae-jin was not one of them.

“Can I show you the imaging first?”

Kim In-soo had hoped Suhyuk would just say, ‘I just thought about it,’ and let it go,

but Suhyuk brought up the imaging as if he was about to give a full presentation.

It was the same imaging he had seen before the rounds yesterday.

The MRI image of Patient Park Sang-a’s liver, clearly showing the masses.

‘It looks like a metastasis no matter how you look at it.’

Professor Cho Tae-jin and Kim In-soo tilted their heads in unison, thinking the same thing.

But seeing Suhyuk’s confident face, they couldn’t help but think it might not be.

It was a situation that would make anyone laugh out loud,

but in reality, it wouldn’t be that easy to laugh it off.

Over the past week, Suhyuk had shown truly remarkable performance.

To the point where one might think the professor could have high expectations for a first-year resident.

“Go ahead.”

While thinking this, Professor Cho Tae-jin pointed at the imaging with his chin.

Suhyuk nodded silently and pointed to the masses clearly visible in the liver.

They were dark compared to the surrounding liver tissue, consistent with metastatic lesions from colon cancer.

“Look closely... The borders seem a bit broken, don’t they?”

“Huh?”

“See here, these masses... The borders are not clean.”

“Hmm.”

Listening to Suhyuk, it did seem that way.

Suhyuk continued, addressing the two who were nodding.

“As you know, metastatic lesions from colon cancer to the liver have very, very clear borders. Here... This is a captured image of the current patient.”

“Hmm... Yes, that’s true. But in the current situation, metastasis is the most likely cause for these multiple masses. Just that alone isn’t enough to differentiate.”

Professor Cho Tae-jin said this with a face that seemed to find it quite interesting.

It was plausible, but not yet convincing.

Of course, Suhyuk didn’t bring it up just for that.

He moved on to the next point as if he had been waiting for it.

“Yes, sir. But... Look at the brightness.”

“Brightness?”

“Patient Park Sang-a’s masses are a bit brighter, aren’t they? Compared to the masses of patients confirmed to have metastasis?”

“Oh... This... Why is this...?”

It was a characteristic that wasn’t noticeable when viewed separately.

For someone who couldn’t record it as meticulously as Suhyuk with Baruda’s help, it might be difficult to distinguish.

Even Professor Cho Tae-jin, despite being a hematology-oncology professor, didn’t spend all day looking at images like a radiologist, making it even more challenging.

“There’s a reason.”

Suhyuk, as always, paused before making an important statement.

“What is it? Speak quickly.”

Even Professor Cho Tae-jin was intrigued.

He had long forgotten that he was testing Suhyuk.

He was already captivated by Suhyuk’s logic and reasoning.

Kim In-soo was no different.

‘What is it? What is it, really?’

Although he couldn’t speak with Professor Cho Tae-jin beside him,

his eagerness for Suhyuk to continue was no less than the professor’s.

“In Korea, we often use Primovist as a contrast agent for MRI.”

“Primovist, what?”

“Primovist.”

“What... What’s the connection?”

Professor Cho Tae-jin asked, expecting a significant connection.

Suhyuk nodded, as if determined not to disappoint that expectation.

[Suhyuk seems to have more talent for acting than medicine. I would have said it right away.]

‘But it wouldn’t look as impressive, man.’

[That’s right. According to my analysis, the emotional state of Cho Tae-jin and Kim In-soo is 100% anticipation.]

Baruda was also in the process of analyzing human emotional expressions based on Suhyuk’s facial expressions.

To Suhyuk, it seemed like a pointless task,

but Baruda insisted that it would be useful to have the data.

“Primovist costs about 150,000 won per vial, so it’s rarely used abroad, but in Korea, it’s commonly used because liver cancer is prevalent.”

“What’s its characteristic?”

“It’s absorbed very well by liver cells.”

“Oh?”

Professor Cho Tae-jin’s face showed a hint of understanding.

Kim In-soo quickly followed suit, mimicking the professor’s expression.

Suhyuk looked at the two with a very satisfied face and pointed to the image he had displayed earlier.

“Let’s look at the image again. The masses of Patient Park Sang-a and the masses of a patient confirmed to have metastasis.”

“Hmm.”

Professor Cho Tae-jin and Kim In-soo stared at the image without saying a word.

The masses of Patient Park Sang-a, which they had assumed to be metastatic until yesterday, began to look distinctly different from the masses caused by actual metastasis.

“Brighter... Definitely brighter. So?”

“It means Primovist was absorbed. Not as much as in healthy liver cells, but it was absorbed.”

“I see...”

“If these masses were from colon cancer metastasis, they wouldn’t absorb at all. There are no liver cells in the colon. Like the masses in this patient.”

Suhyuk pointed to the completely dark masses of a liver metastasis patient.

Professor Cho Tae-jin nodded, still in a daze, pointing to the masses of Patient Park Sang-a.

“Then this... What is it? Liver cancer...? No, it doesn’t look like liver cancer.”

“It’s a lesion originating from liver cells.”

“What kind?”

“This patient used FOLFOX for chemotherapy. The regimen includes oxaliplatin.”

“Oh, I see!”

Finally, Professor Cho Tae-jin nodded with a confident face.

Kim In-soo, still not quite getting it, was trying to mimic Professor Cho Tae-jin’s expression.

He nodded faintly, as if he had figured something out.

“Oxaliplatin is a drug that causes toxicity in liver cells. So these masses are local liver lesions caused by chemotherapy, not metastasis from colon cancer.”

Suhyuk concluded his brief but intense presentation, looking at the two.

Professor Cho Tae-jin stared at him for a moment before finally speaking.

“Wow... You, really...”

His face was almost moved to tears.