Chapter 40: If Not Delirium, Then What? (2)

Delirium usually came at night.

But it wasn’t like Cinderella, where it would arrive at a specific time.

Especially at 2:00 PM, an extremely awkward time, it was even stranger.

Thud.

Suhyeok looked down at the patient who was now completely out, lost in thought.

As usual, he was talking to Baruda.

'2:00 PM...'

[Let's pretend I didn't hear your thoughts about the circadian rhythm.]

'Well, I thought it was ridiculous, so I didn't say it.'

[But it's strange. Delirium at the same time every day. What kind of periodic event could it be?]

'Hmm.'

Suhyeok closed his eyes for a moment, recalling the schedule of the intensive care unit.

'First, visiting hours. They're at a fixed time.'

[The patient who had delusions about his wife came to see her at a fixed time... Is there a connection? That seems a bit far-fetched.]

'Yeah, it does.'

Why would delusions be delusions if they had any real basis?

They were delusions because there was no realistic connection.

Just because a patient had delusions about his wife having an affair, it didn't mean the husband usually suspected his wife.

'Ward round?'

[Ward round.]

In a survey of patients who had experienced delirium while in the ICU, there was a rather shocking response.

At the time, the nurses and other medical staff who were moving around were seen as demons trying to torment them.

From that perspective, the ward round could be a trigger, which made some sense.

'But the possibility is low. What could it be?'

[I have no idea.]

'Hmm...'

Suhyeok tilted his head and looked down at the patient.

No matter how long he stared, the answer didn't come.

He just felt frustrated.

With that frustration, he completed the ward round and a few hours later, evening arrived.

[For now, I suggest you go up and study, then go to bed. Thinking more won't change anything.]

'Yeah, I need to look into delirium more.'

[That's a good idea.]

Anyone who has taken an exam knows that.

Holding onto an unknown problem won't help.

It's just a waste of time.

Especially when you have plenty of time to study, like now.

So, Suhyeok agreed with Baruda and headed to the on-call room.

The on-call room was empty.

'That's strange. I heard it's usually not this quiet.'

Strangely, Suhyeok had been using the room alone.

Even when the on-call room was crowded, people would quietly move to other rooms when he entered.

[Isn't that a good thing? Good for studying and good for sleeping.]

'Yeah, I guess.'

There were many issues with sleeping in a room full of on-call doctors.

First, he had to wake up every time another on-call doctor got a call.

Plus, why did they snore so loudly?

For someone sensitive, it was impossible to sleep.

You could use earplugs, but then you might miss your own calls.

It was almost like hell.

'What about... delirium...'

[Let's look at something other than what you've seen before.]

'I've already looked at the textbooks.'

[Then look at papers.]

'Oh... already looking at papers...'

[Others start looking at papers even in their fourth year of medical school.]

'Oh.'

Suhyeok tried to ignore Baruda's comment and started flipping through papers.

Finding the right paper used to be a task in itself.

But thanks to his recent extensive reading, he was quite efficient at it.

As a result, he was able to quickly pull up dozens of papers.

'Hmm...'

[Hmm...]

'Ugh...'

[Hmm...]

But he didn't find anything particularly useful.

Delirium at 2:00 PM every afternoon?

There was no paper on that.

In the end, Suhyeok had to go to sleep without resolving his curiosity.

'If this was a situation where the patient's vital signs were fluctuating, it would be terrifying.'

If that were the case, the patient might already be dead.

[That's why you need to gather more data regularly. You're still lacking.]

'Yeah... I guess.'

For a first-year, he was doing well, but he still had a long way to go.

'Nothing will happen overnight, right?'

[It could still be simple delirium.]

'Really?'

[No, in medicine, there are no coincidences.]

'Right. Hmm... What could it be...'

Delirium at a fixed time.

What could it be?

Suhyeok pondered this and finally fell asleep.

The next day, he woke up and, as soon as the morning ward round was over, headed straight to the ICU.

'Today is also really short.'

[This is the first time I've seen such a lackluster ward round.]

The endocrinology team, consisting of Seo Hyosuk, Kim Jin-yong, and Hwang Seon-woo, was a complete disaster.

No one was paying close attention to the patients.

At least Kim Jin-yong, who had been demoted from chief resident, was understandable.

He must have been frustrated since it wasn't his job.

But why was Hwang Seon-woo like that?

'He didn't even know I had changed all the prescriptions to prevent any accidents.'

[He doesn't even do the ward round.]

'Yeah... So I'm doing it. I... how did I end up...?'

Strictly speaking, Suhyeok wasn't originally the type to be overly enthusiastic.

But he was a person with a sense of responsibility.

The others lacked that.

[At least Suhyeok is here. It's fortunate that there are few patients, isn't it?]

As a result, Suhyeok was now in charge of all the patients admitted under Professor Seo Hyosuk.

If there were more, he would have been overwhelmed.

According to Baruda, there were fewer than ten patients.

Professor Seo Hyosuk was always transferring patients to other departments, and other departments weren't sending patients to him.

Even the emergency room on-call doctors knew this and tried to admit patients to other endocrinology professors, rarely notifying Seo Hyosuk.

'Yeah... I guess. I mean, how can there be such people?'

[Compared to them, Suhyeok is a truly excellent doctor. I admit it.]

'Compared? Why add that qualifier?'

[You know the reason better than anyone.]

Suhyeok got into the elevator, which was hidden in a corner of each ward, with Baruda's sarcasm.

It was the elevator used to transport food trays during meal times, and patients and their families didn't even know it existed.

Professors rarely used it because they had their own dedicated elevators in the research area.

This meant it could be used for private movement.

Ding.

But at the fifth floor, a professor got on.

Someone Suhyeok knew very well.

"Hey, Suhyeok. Where are you going?"

It was Professor Shin Hyuntae.

'Oh... The director's office is on the fifth floor...'

It seemed he had just been chatting with Professor Lee Hyunjong.

He was probably heading to the outpatient clinic on the first floor.

"Hello, Chief. I'm going to the ICU."

"ICU? Don't they usually give critical patients to second or third-year residents? Surely not Professor Seo?"

"No, not that. The insulinoma patient I had was transferred to surgery, so I'm just checking on them daily."

"Oh... I see. As the attending physician, you should. Suhyeok, you have a good attitude."

"Thank you, Chief."

"Alright, take care. If you have any problems, let me know."

"Yes, Professor."

Suhyeok was about to get off at the third floor.

Or, he was about to.

If Shin Hyuntae hadn't pressed the open button.

"Wait, wait."

"Yes, Professor."

"Next month, you're in cardiology, right?"

Cardiology.

It was a schedule that almost all residents feared.

Not only because it dealt with the dynamic organ, the heart, but also because the professors who specialized in it had dynamic personalities.

They were the wildest people in the entire internal medicine department.

"Yes, Professor."

"Did you know that the director's attending physicians are usually second or third-year residents?"

"Yes."

Among them, Lee Hyunjong was a legend.

His achievements were so great that no one could touch them.

He had rewritten the global cardiology textbooks.

If he moved to another hospital, it would be a significant loss.

'Being an attending physician under him is said to be almost hell...'

There was even a term for it: "cardiology diet."

Residents under Lee Hyunjong would lose weight rapidly.

'I'm nervous...'

Suhyeok looked at Shin Hyuntae with a doubtful expression.

In contrast, Shin Hyuntae had a bright face.

"The director said he wants you, Suhyeok, to take on this attending physician role."

"Ah... Yes, Professor."

Suhyeok unconsciously trailed off, but after Baruda's exclamation, he quickly nodded.

The director had already decided, after all.

Arguing about it would not be wise.

"The director usually does angioplasty and stents."

"Yes, I'll study in advance."

"Good. What else? He's also into arrhythmia these days."

At 60, he was still taking on new fields.

Suhyeok was so surprised his mouth dropped open.

"It would be good to study that in advance. The director has high expectations. I do too. Don't disappoint us."

"Yes, Professor. I'll keep that in mind."

"Good. Work hard."

"Yes."

Shin Hyuntae left with a message that was hard to call good news.

Suhyeok stood in front of the closed elevator door for a moment.

'Attending physician under Director Lee Hyunjong...'

He was a legendary attending physician, known for being meticulous and difficult, even for second-year residents.

And now, a first-year, and on his first rotation in cardiology, was taking on this role.

[Isn't this a good thing? Based on my analysis, Lee Hyunjong likes you.]

'But... that could change. Watching other people's patients is different from watching your own.'

[Just study. It's a good thing.]

'You just keep saying study, study...'

As Suhyeok was about to shake his head while talking to Baruda, a commotion broke out inside the ICU.

The door was closed, so it was hard to hear clearly, but he could make out a few words.

Wife, affair.

'Again?'

[Let's go!]

So, Suhyeok hurriedly moved with his cane.

Even so, he was much slower than running, and by the time he entered the ICU, the situation was already over.

The patient had been given a sedative and was lying down.

[9:00. This is the same as yesterday morning.]

'Morning and evening at the same time?'

[No. There was an event at 2:00 PM yesterday afternoon. It will likely happen again today at 2:00 PM. So, it seems there's a strong connection between the patient's delirium and a regular event at breakfast, lunch, and dinner. What could it be?]

'Hmm...'

[Food?]

Food was served at fixed times.

But could that cause delirium?

That was ridiculous.

'No, that's not it. Besides food, what else is done at fixed times... Oh.'

[Medication?]

'Right. It could be a side effect of the medication!'