Chapter 35, right? (2)

Click.

Suhyuk hurriedly moved his hand to bring up the image of the patient Yang Jae-won.

In the meantime, Professor Kim Jin-sil crossed her arms and looked at Suhyuk intently.

'The director and Chief Shin Hyun-tae keep praising him all the time.'

The way they talk about Suhyuk, Professor Lee Ha-yeon, who is also the deputy director and a professor of radiology, would go into a fit whenever Suhyuk's name came up.

- I know, I know! We don't have such a talent in our department!

Originally, Professor Lee Ha-yeon was almost a legendary figure in the field of abdominal radiology.

He was the first in the country to attempt to burn liver cancer lesions, which had not metastasized or had metastasized from other places, especially the colon, using high-frequency waves without surgery.

Given his reputation, his pride was immense.

The fact that he made such a statement clearly indicated how persistently Lee Hyun-jong had talked about it.

"Here... This is the part, Professor."

While Professor Kim Jin-sil was momentarily lost in thought, Suhyuk brought up the abdominal CT image.

Since Baruda had accurately remembered the CT image number, there was no mistake.

Thanks to this, Jin-sil could see the clearest cut of the lesion as soon as she turned her head.

"Hmm."

It was an image taken shortly after the contrast agent was injected.

This is known as the arterial phase, where lesions that enhance well already show enhancement at this stage.

Just like the tumor right in front of her.

'Head of the pancreas... Enhancement in the arterial phase. The shape... It certainly seems like an insulinoma.'

The problem was that it was impossible to diagnose all diseases based solely on radiological judgment.

Especially for organs like the pancreas, which are soft and mushy, diagnosing with only a CT scan could be very risky.

"What about the clinical symptoms?"

Therefore, it was necessary to consider clinical estimates as well.

Fortunately, Suhyuk had completed his inference to a nearly perfect degree.

"The main symptom now is seizures and convulsions."

"Convulsions?"

"Yes. If hypoglycemia continues chronically, symptoms of the autonomic nervous system, such as restlessness and hand tremors, disappear. Instead, only neurological symptoms like seizures, convulsions, dizziness, and mental confusion remain."

"Oh..."

Upon hearing this, she recalled studying such content.

Although radiologists do not directly see patients, they do a lot of studying.

She could understand it immediately.

"And the patient's blood sugar does not drop below 50 when symptoms appear. It improves with glucose administration."

"Consistent with Whipple's triad."

"Yes. In addition, there are specific radiological findings. Therefore, I diagnosed it as an insulinoma."

"Hmm."

Professor Kim Jin-sil looked at the image again based on Suhyuk's words and other test results.

Indeed, considering the symptoms and blood tests comprehensively, it was difficult to think of any other disease besides an insulinoma.

'This kid... He really is a genius.'

From the records, the patient came in due to seizures and convulsions.

The patient's guardian thought these symptoms were due to not receiving a divine revelation.

It was not a situation to blame, as no hospital had given a clear diagnosis.

A first-year internal medicine resident, who went for a consultation on hypoglycemia, made the diagnosis.

It was a diagnosis that even secondary hospitals and psychiatric clinics had missed.

'What would happen if I told Professor Lee Ha-yeon about this?'

It would likely cause a commotion.

He always thought that raising just one Kim Jin-sil was insufficient.

"Ah, but... Why is this patient in the emergency room? It doesn't seem like they've been admitted to a ward?"

While thinking about this, Jin-sil noticed that the patient's chart was floating in front of the emergency room.

It was strange.

Why was the patient still in the emergency room when the diagnosis was complete?

She turned to look at Suhyuk, wondering if there were no available rooms.

"That's..."

However, Suhyuk, who had been showing a sharp demeanor all along, hesitated.

Jin-sil, who had extensive experience in a university hospital, immediately sensed that something was amiss.

'Now that I think about it... There's a resident on duty, yet he came to me specifically?'

It was fortunate that she had heard of Suhyuk's name.

Otherwise, she would have found it absurd and told him to leave.

Or she might have asked the resident first and told him to come if the resident didn't know.

In any case, it was not a normal situation.

"It's fine, so tell me. There's nothing to do anyway."

Professor Kim Jin-sil deliberately looked around.

The computers in the reading room, which would usually be full on a weekday, were empty.

Suhyuk also turned his head to follow her gaze and thought there was indeed nothing to do.

"That..."

"What is it?"

"I notified, but the third-year resident said it's too rare a disease, an insulinoma."

"Rare? What does that have to do with leaving the patient in the emergency room?"

Suhyuk thought again in response to Jin-sil's reaction.

'Ah... I was supposed to say I didn't notify. What should I do?'

[Suhyuk, it's almost June.]

'What's that?'

[Kim Jin-yong will step down from his chief position in October to prepare for the specialist exam.]

'Ah...'

In the past, when internal medicine was a four-year program, residents didn't come to the hospital.

This was because the internal medicine specialist exam covered the entire field of medicine.

In terms of the amount of study required, internal medicine was the most demanding among all specialties.

However, with the current three-year program, residents don't completely avoid the hospital.

Still, they are largely excluded from duties.

This means they are also excluded from power.

[Even if he fails, it's fine. Kim Jin-yong has to go to the military, so when he returns, Suhyuk will be in a higher position.]

'That... That's true.'

It was a very tempting offer.

Almost like a devil's proposal.

Baruda continued to speak while Suhyuk was in a trance.

[Moreover, the presentation tomorrow is only for Kim Jin-yong. If that happens...]

'He will claim he diagnosed the insulinoma.'

[The analysis results show he will do more than that.]

'Can't do that?'

[But what if other professors find out that Suhyuk diagnosed the insulinoma?]

'That will continue. Even now... actually, the professors treat me specially.'

Suhyuk nodded as if he had made a decision.

After thinking about it, he realized there was no reason to yield to the bastard Kim Jin-yong.

If he were just a regular first-year, he might have had to, but Suhyuk had exceptional skills that could overshadow everything.

And there was no reason not to use them, thanks to Baruda.

"The third-year resident said he couldn't believe the judgment of a first-year."

"Oh, so he's coming now?"

"That's... No. He said we'll meet tomorrow morning."

"Morning? Leaving the patient in the emergency room?"

"Yes."

"I don't understand. Who is this person?"

Suhyuk hesitated again whether to speak or not.

[Go.]

He was completely swayed by Baruda's urging.

"Dr. Kim Jin-yong."

"Kim Jin-yong? I've heard that name somewhere."

Professor Kim Jin-sil tilted her head and then met the eyes of her resident, slamming her desk.

"Oh, that... Yeah."

The first-year who entered, the one who had made her life miserable during her internship, was Kim Jin-yong.

In fact, the current third-year residents would try to give better readings for Kim Jin-yong's patients.

She looked at Suhyuk, thinking the rumors were not baseless.

"Anyway, so the patient is in the emergency room... Why did you get the reading from me?"

"That... Dr. Kim Jin-yong said to get a formal reading from a professor, not just a verbal one from a resident."

"Until tomorrow?"

"Yes."

"Hmm."

Kim Jin-sil immediately understood what was happening.

It seemed that the incompetent third-year, Kim Jin-yong, was trying to make life difficult for Suhyuk.

'He probably thought it couldn't be an insulinoma.'

It wasn't entirely wrong.

It was indeed a very rare disease.

'But Suhyuk was right.'

And it just so happened that Professor Kim Jin-sil, who was part of the Lee Hyun-jong and Lee Ha-yeon line, had just found out about this.

"What treatment is the patient receiving? Dexamethasone?"

"Yes. The treatments available in the emergency room are limited."

"But given the severe neurological symptoms... and the size here, it seems medication alone won't be enough?"

"Yes. We need to urgently provide glucose when the blood sugar drops."

"The best place for that in our hospital is the endocrinology ward, right?"

"Yes, Professor."

Nurses, of course, do not have the same level of specialization as doctors.

However, hospitals and medicine vary greatly by specialty.

Even among nurses, their experience and expertise differ based on where they have worked.

In other words, the safest place for an endocrinology patient is not the emergency room but the endocrinology ward.

"So, we need to admit the patient there."

"But I don't have the authority..."

"Just wait. I'll call Chief Shin Hyun-tae... Do you have his number?"

"Yes? The chief?"

"Yes. It's a department matter, so I need to inform him."

"Uh..."

Suhyuk thought the situation was getting bigger than he had anticipated.

Professor Kim Jin-sil patted his shoulder, which had turned slightly dark.

"Don't worry. I won't make it difficult for you."

"Ah, yes."

"Got it."

Then she exchanged casual greetings with Chief Shin Hyun-tae.

They had become quite close, and Chief Shin was now completely informal with Professor Kim.

"Are you playing golf?"

"I don't know what's going on today. It seems the director is playing."

"Playing? 18 holes?"

"Yeah. Are you crazy? Are you secretly taking lessons? But what's up? I heard you're on duty today."

"Oh... That Suhyuk. You know him?"

"Suhyuk? I know. We're close."

Professor Kim Jin-sil shook her head at Chief Shin's exaggerated words and continued.

"He hit another home run today."

"What? Really? Oh, I saw it earlier. You're on duty, right? What's up?"

"A patient was transferred to psychiatry with seizures and convulsions."

"Oh. What was it?"

"An insulinoma. He caught the neurological symptoms due to chronic hypoglycemia and ordered an abdominal CT."

"Wow... How did he connect that? Anyway, he's really a genius."

Chief Shin, who had been frustrated with his golf game, now seemed to be relieved, shouting loudly.

This made Lee Hyun-jong, who was probably about to swing at the last hole, foam at the mouth.

"Mind your manners! Who's swinging a driver and shouting?"

"It's hospital business, director. Hospital business."

"Look at him making excuses. I should have caught him earlier."

"Anyway, he made the diagnosis. Why did you call?"

Chief Shin, satisfied that he had lost his chance to swing, asked Professor Kim Jin-sil.

She responded as if she had been waiting for this question.

"I also saw the images and confirmed it was an insulinoma. So I told them to admit the patient and consult the surgery department."

"But?"

"The third-year resident won't admit the patient."

"What?"

What kind of crazy talk is this?

Naturally, Chief Shin shouted, and Lee Hyun-jong missed his shot.

Amidst Lee Hyun-jong's shouting, Professor Kim Jin-sil continued.

"He said it's a rare diagnosis and it can't be right, so he won't admit the patient."

"Did he come to see the patient?"

"No. He said he'll come tomorrow."

"Who... Who is this guy?"

"Kim Jin-yong? I think that's his name."

"This guy is dead. Hang up."

"Yes, Chief."