Chapter 34, right? (1)

[Insulinoma! Insulinoma!]

Of course, Baruda had already completed the analysis before Suhyuk even opened his mouth.

It's just that Suhyuk wasn't paying attention to what he was saying.

[I've told you a hundred times! Insulinoma!]

'If I keep hearing it, it sounds like a curse. Can you be a bit quieter? You slowpoke?'

[Wow... Wow... I just guessed it based on the data I've accumulated!]

'Guessing is bullshit. I'm just a genius. Even more so than I thought.'

[Wow...]

After silencing Baruda, Suhyuk finally told Kim Jin-yong what he believed to be the correct answer.

"I suspect insulinoma."

"Ins... What?"

"Insulinoma. There are also suspicious lesions visible on the CT scan."

"Hey..."

Kim Jin-yong could only say "Hey" and couldn't continue, as he had heard of it but couldn't immediately recall it.

However, Suhyuk wasn't the type to lack social skills, even to the point of pushing a notorious third-year like Kim Jin-yong.

Of course, he often made involuntary mistakes due to Baruda.

'Shit... Where have I heard of it before?'

Thanks to this, Kim Jin-yong managed to buy some time.

As he thought more deeply, he realized he had seen it once before.

'It's supposed to be extremely rare, right?'

Insulinoma.

One of the benign tumors that can occur in the pancreas.

It can be suspected when there are symptoms of uncontrolled excessive insulin, but it is an extremely rare condition.

It's so rare that even residents in small hospitals might not see a single case in three years.

And he diagnosed it in the emergency room?

And he's only a first-year?

Kim Jin-yong felt more anger than disbelief.

'This kid is acting like he's a genius... Even though he's a dirt-poor nobody about to be exposed to the whole world.'

He wanted to give him a big slap.

'Besides... Professor Seo Hyo-suk... He'll go ballistic if I notify him on the weekend.'

He hated being contacted on weekends so much that he wondered why he didn't open his own clinic instead of staying at the university hospital.

Notifying a third-year based on a first-year's word would be insane.

So he had to go to the hospital, see the patient, and notify him in person.

Neither Seo Hyo-suk nor Kim Jin-yong liked being contacted on weekends.

So he decided to start with Suhyuk.

This was the easier and more convenient way.

"Hey, do you know how rare insulinoma is?"

"Ah... Yes, I know."

It was so rare that it was meaningless to talk about the incidence rate per 100,000 people.

But Suhyuk had found numerous pieces of evidence beyond the imaging.

His answer was without hesitation.

To Kim Jin-yong, it sounded extremely annoying.

"This kid... Does he think he's a senior resident or something? Why are you so confident?"

"Me? Ah... I'm sorry."

Suhyuk was very flustered by the sudden confrontation.

[Why is this kid like this again?]

Baruda, also flustered, started cursing.

But Suhyuk couldn't do that.

He was a first-year and didn't know the rumors about him.

So he started with an apology.

"Sorry? If you knew you were sorry, you wouldn't have notified me with such an out-of-the-blue diagnosis."

"I'm sorry."

As Suhyuk repeated his apology, he could deeply feel why Kim Jin-yong was known as a bastard.

It wasn't by chance that he became the public enemy of the lower years, despite not being particularly skilled.

"Organize why you think the patient has insulinoma by the time I do rounds tomorrow. At least ten slides, including information about insulinoma itself."

"Ah... Should I admit the patient first, then?"

"Are you crazy? See him in the emergency room."

"Admit... him?"

Suhyuk involuntarily turned to look at the patient.

The patient, who had just come out of the effects of the sedative, was looking around with a dazed expression.

Leaving him in the emergency room like this?

It wouldn't be medically or ethically right.

"Yeah, admit him. What the hell, calling a third-year on the weekend for something that's not even certain. This is all because of your damn luck."

But arguing for admission again would be suicidal.

Kim Jin-yong was not someone who could be reasoned with.

After cursing a few more times, he finally said something meaningful.

"Listen carefully. You never notified me, got it?"

"Ah, yes, sir."

"And if I go tomorrow and your presentation is inadequate, you're dead, got it?"

"Yes."

Since Suhyuk didn't think the evidence was inadequate, he nodded obediently.

This firm answer made Kim Jin-yong even angrier.

It touched his inferiority complex.

"You said you did a CT scan, right? A first-year doing a CT scan without notifying anyone, what a great job, what a great job."

So he pushed his luck, even though the prescription authority should be given to the doctor who saw the patient.

"Go to the radiology department and get the CT read."

"Yes."

"By a professor, not a resident."

"By... tomorrow?"

"Yes. You said the diagnosis, right? So get a proper read from a professor, not just a verbal one from a resident. If you're that confident."

Suhyuk couldn't confidently answer this.

To patients, radiology might just be another department.

But in this university hospital, radiology was the top of the top.

How else would there be a saying that even the chiefs of other departments have to cater to the moods of first-year radiology residents?

And a mere first-year asking for a professor's read?

On a weekend, when the professor is likely not even there.

This was a death sentence.

"Hey, why aren't you answering? Are you ignoring me?"

"Ah... No, sir."

"Tomorrow. Do everything I said by tomorrow."

Kim Jin-yong, seemingly pleased with Suhyuk's hesitant answer, hung up with a low smile.

'Where does this dirt-poor kid get off... causing a scene in someone else's presentation?'

He finally felt like he had repaid the humiliation he suffered during the presentation.

"Hey! Aren't you going to guard the tower?"

Besides, his game was urgent.

So Kim Jin-yong put down his phone with a low smile.

Swish.

Suhyuk also put his phone in his gown pocket.

[Compared to Kim In-su, you're worlds apart.]

Then Baruda, who had been silent, spoke up.

'Even though Professor Kim In-su is a bit cold... He doesn't pass his work to others. He's smart too.'

[There are rumors that he will become a military fellow.]

'This guy... is really a bastard.'

[But he is a senior. You have to follow his instructions.]

'Ah, I'm so annoyed.'

Suhyuk shook his head and looked at the patient.

If the mass seen on the CT is indeed an insulinoma, he should be admitted immediately to schedule surgery.

But in the current situation, where the patient is in the emergency room, he can't even consult with a surgeon.

Surgery for uncontrolled insulinoma is extremely risky, and Suhyuk doesn't have the authority to do so.

[Do the treatment you can do here, Suhyuk.]

Baruda spoke to Suhyuk, who was deep in thought.

As usual, his tone was emotionless, but it was the right advice.

'I have to do that.'

[In a situation where surgery is not possible, I recommend diazoxide (an insulin secretion inhibitor).]

'Is that drug even available here? It's a rare medication.'

[This is Tae-hwa Medical Center. We have every medication available in Korea.]

'Sure.'

Suhyuk nodded and stood up.

His face was more relaxed than right after the call.

Diazoxide would buy them a lot of time.

It's a drug that blocks insulin secretion from the beta cells of the pancreas and is the optimal treatment when surgery is not immediately possible.

"What happened?"

As he moved to the patient, Oh Jin-seung approached and asked, his face showing concern.

He must have overheard some of the conversation.

"The first-year gave a very rare diagnosis, and it didn't sit well with him. I got scolded."

"Jin-yong is usually like that. He does it to seniors too, so don't take it to heart."

"Yes, but... I can't admit the patient, which is a bit of a problem."

"Is it a dangerous situation here? Maybe we should admit him to the psychiatric ward for a while?"

Suhyuk felt a moment of temptation at Jin-seung's suggestion.

But thinking about the patient, he shook his head.

The psychiatric ward might be less safe than here.

The nurses here, while not specialized in endocrinology emergencies, were veterans in almost all emergency situations.

"No, brother. Since I'm on duty anyway... I can handle it here."

"Okay... If you need to interview the patient or talk to the family, call me."

"Yes, brother. Thank you."

"Sure. I have another call. See you later."

"Yes."

Maybe because he had just talked to Kim Jin-yong, it felt like a halo was shining around Oh Jin-seung's back as he walked away.

Such a person in this cold university hospital.

He was a saint.

[Let's start the treatment.]

But there was no time to keep standing around.

So Suhyuk followed Baruda's advice and prescribed diazoxide.

As expected, the unfamiliar prescription required a nurse to confirm before administering it to the patient.

The patient, still looking confused, didn't refuse the medication.

And the medication seemed quite effective, as he showed no symptoms for several hours after administration.

[The patient seems stable. The last blood glucose test was over 90.]

'Then... I have to go to the radiology department.'

[Will the professor be there on the weekend?]

'They will be. This is Tae-hwa Medical Center.'

What's the best thing about a big hospital?

There are other good things, but...

The best thing is the abundance of staff.

Other hospitals might be empty on weekends, but not here.

"Are you going to request a read directly from a professor?"

The radiology on-call resident, a third-year, looked at Suhyuk as if he were crazy.

Even requesting a read from a resident would be a daunting task, let alone a professor.

"Yes, sir. There's a reason for it. Is the abdominal on-call professor in the hospital today?"

"Let me check... Ah, Professor Kim Jin-sil... She came to look at an ultrasound for a liver transplant patient. She's coming this way."

The resident pointed to the approaching professor, thinking, "You're the one who's going to die, not me."

The professor, with her tightly tied hair, looked sharp overall.

Her personality seemed to match, as the resident silently prayed.

But Suhyuk couldn't defy Kim Jin-yong's orders.

So he cautiously approached Professor Kim Jin-sil and greeted her.

"Hello, Professor Kim Jin-sil. I'm Suhyuk, a first-year in internal medicine."

"Suhyuk? Ah, the actinomycosis case. What's up?"

But Professor Kim Jin-sil's reaction was surprisingly friendly.

For some reason, she even offered him a seat.

"Ah, thank you. I have a patient with persistent hypoglycemia and accompanying neurological symptoms. Can I request a read of the abdominal CT?"

"Hmm. Show me the images. What are you suspecting?"

"Insulinoma."

"Oh, that's quite rare. Let's see... Is it correct?"